{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T02:27:00Z","timestamp":1773973620056,"version":"3.50.1"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004375","name":"Tel Aviv University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore FEES findings obtained using different liquid types, water, cow\u2019s milk, and soy milk, with respect to observed penetration, aspiration, and pharyngeal residue, and to describe agreement across liquids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients referred to a university-affiliated dysphagia clinic underwent standardized FEES using water, cow\u2019s milk, and soy milk during single and consecutive swallows. Evaluations were performed jointly by a laryngologist and a speech-language pathologist (SLP). Outcome measures included the Penetration\u2013Aspiration Scale (PAS) and the Yale Pharyngeal Residue Severity Rating Scale. Inter-rater reliability was assessed through blinded reassessment of 25% of examinations by an additional laryngologist and two SLPs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most swallows across all liquids were classified as safe. Unsafe PAS scores occurred numerically more frequently with cow\u2019s milk (18.2\u201325.6%), than with water (6.9\u201311.6%) or soy milk (9.4\u201311.6%). For single swallows, a nominal overall difference across liquids was observed (Cochran\u2019s Q = 6.00, p = 0.050), and for consecutive swallows an overall difference was also detected (Cochran\u2019s Q = 8.00, p = 0.018). Pairwise comparisons were not statistically significant after correction for multiple testing. No statistically significant differences were identified between liquids for vallecular or pyriform sinus residue. Agreement in PAS scores across liquids ranged from low to moderate (\u03ba = 0.291\u20130.609), and agreement for residue scores ranged from moderate to almost perfect (\u03ba = 0.528\u20130.824). Inter-rater reliability was excellent (ICC = 0.93, 95% CI [0.90-0.95], p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this exploratory within-subject study, no statistically significant differences were observed in FEES penetration, aspiration, or pharyngeal residue scores when using water, cow\u2019s milk, or soy milk. These findings provide preliminary descriptive data regarding the behavior of a commonly consumed plant-based liquid during FEES and may inform future research on liquid properties in swallowing assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-025-10005-x","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T17:22:07Z","timestamp":1769016127000},"page":"1803-1810","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The effect of liquid type on the detection of airway invasion during swallow evaluation"],"prefix":"10.1007","volume":"283","author":[{"given":"Eiman","family":"Abu Bandora","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liav","family":"Hayat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yarden","family":"Ashkenazi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yael","family":"Oestreicher-Kedem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nogah","family":"Nativ-Zeltzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6202-4647","authenticated-orcid":false,"given":"Yuval","family":"Nachalon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"10005_CR1","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1016\/j.jamda.2022.05.019","volume":"19","author":"B Labeit","year":"2022","unstructured":"Labeit B, Ahring S, Boehmer M et al (2022) Comparison of simultaneous swallowing endoscopy and videofluoroscopy in neurogenic dysphagia. J Am Med Dir Assoc 19:1360\u20131366. https:\/\/doi.org\/10.1016\/j.jamda.2022.05.019","journal-title":"J Am Med Dir Assoc"},{"issue":"1","key":"10005_CR2","first-page":"1","volume":"3","author":"N Rao","year":"2003","unstructured":"Rao N, Brady SL, Chaudhuri G, Donzelli JJ (2003) Gold-standard? Analysis of the videofluoroscopic and fiberoptic endoscopic swallow examinations. J Appl Res Clin Exp Ther 3(1):1\u20136","journal-title":"J Appl Res Clin Exp Ther"},{"key":"10005_CR3","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1007\/s00455-001-0113-1","volume":"17","author":"N Colodny","year":"2002","unstructured":"Colodny N (2002) Interjudge and intrajudge reliabilities in fiberoptic endoscopic evaluation of swallowing (FEES\u00ae) using the penetration-aspiration scale: a replication study. Dysphagia 17:88\u2013100. https:\/\/doi.org\/10.1007\/s00455-001-0113-1","journal-title":"Dysphagia"},{"key":"10005_CR4","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1016\/j.mcna.2016.12.006","volume":"101","author":"BR Kollmeier","year":"2017","unstructured":"Kollmeier BR, Keenaghan M (2017) Aspiration risk. Med Clin North Am 101:525\u2013535. https:\/\/doi.org\/10.1016\/j.mcna.2016.12.006","journal-title":"Med Clin North Am"},{"issue":"1","key":"10005_CR5","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1378\/chest.124.1.328","volume":"124","author":"PE Marik","year":"2003","unstructured":"Marik PE, Kaplan D (2003) Aspiration pneumonia and dysphagia in the elderly. Chest 124(1):328\u2013336. https:\/\/doi.org\/10.1378\/chest.124.1.328","journal-title":"Chest"},{"key":"10005_CR6","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/818979","volume":"2011","author":"L Rofes","year":"2011","unstructured":"Rofes L, Arreola V, Almirall J et al (2011) Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterol Res Pract 2011:818979. https:\/\/doi.org\/10.1155\/2011\/818979","journal-title":"Gastroenterol Res Pract"},{"key":"10005_CR7","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1007\/s00455-020-10133-4","volume":"36","author":"JA Curtis","year":"2021","unstructured":"Curtis JA, Seikaly ZN, Dakin AE, Troche MS (2021) Detection of aspiration, penetration, and pharyngeal residue during FEES: comparing the effects of color, coating, and opacity. Dysphagia 36:207\u2013215. https:\/\/doi.org\/10.1007\/s00455-020-10133-4","journal-title":"Dysphagia"},{"key":"10005_CR8","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1007\/s00455-016-9703-0","volume":"31","author":"S Marvin","year":"2016","unstructured":"Marvin S, Gustafson S, Thibeault S (2016) Detecting aspiration and penetration using FEES with and without food dye. Dysphagia 31:498\u2013504. https:\/\/doi.org\/10.1007\/s00455-016-9703-0","journal-title":"Dysphagia"},{"key":"10005_CR9","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1007\/s00455-005-0019-4","volume":"20","author":"SB Leder","year":"2005","unstructured":"Leder SB, Acton LM, Lisitano HL, Murray JT (2005) Fiberoptic endoscopic evaluation of swallowing (FEES) with and without blue-dyed food. Dysphagia 20:157\u2013162. https:\/\/doi.org\/10.1007\/s00455-005-0019-4","journal-title":"Dysphagia"},{"key":"10005_CR10","doi-asserted-by":"publisher","first-page":"1262","DOI":"10.1044\/2019_AJSLP-19-0005","volume":"28","author":"J Curtis","year":"2019","unstructured":"Curtis J, Perry S, Troche MS (2019) Detection of airway invasion during flexible endoscopic evaluations of swallowing: comparing barium, blue dye, and green dye. Am J Speech Lang Pathol 28:1262\u20131268. https:\/\/doi.org\/10.1044\/2019_AJSLP-19-0005","journal-title":"Am J Speech Lang Pathol"},{"key":"10005_CR11","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1016\/j.pmr.2008.05.003","volume":"19","author":"SB Leder","year":"2008","unstructured":"Leder SB, Murray JT (2008) Fiberoptic endoscopic evaluation of swallowing. Phys Med Rehabil Clin N Am 19:787\u2013801. https:\/\/doi.org\/10.1016\/j.pmr.2008.05.003","journal-title":"Phys Med Rehabil Clin N Am"},{"issue":"2","key":"10005_CR12","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1177\/000348940911800204","volume":"118","author":"SG Butler","year":"2009","unstructured":"Butler SG, Stuart A, Kemp S (2009) Flexible endoscopic evaluation of swallowing in healthy young and older adults. Ann Otol Rhinol Laryngol 118(2):99\u2013106. https:\/\/doi.org\/10.1177\/000348940911800204","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"1","key":"10005_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/000348941112000101","volume":"120","author":"SG Butler","year":"2011","unstructured":"Butler SG, Stuart A, Case LD, Rees C, Vitolins M, Kritchevsky SB (2011) Effects of liquid type, delivery method, and bolus volume on penetration-aspiration scores in healthy older adults during FEES. Ann Otol Rhinol Laryngol 120(1):1\u20137. https:\/\/doi.org\/10.1177\/000348941112000101","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"10005_CR14","doi-asserted-by":"publisher","first-page":"2147","DOI":"10.1002\/lary.21116","volume":"120","author":"SG Butler","year":"2010","unstructured":"Butler SG, Stuart A, Leng X, Rees C, Williamson J, Kritchevsky SB (2010) Factors influencing aspiration during swallowing in healthy older adults. Laryngoscope 120:2147\u20132152. https:\/\/doi.org\/10.1002\/lary.21116","journal-title":"Laryngoscope"},{"key":"10005_CR15","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1007\/s00455-016-9775-x","volume":"32","author":"SE Langmore","year":"2017","unstructured":"Langmore SE (2017) History of fiberoptic endoscopic evaluation of swallowing for evaluation and management of pharyngeal dysphagia: changes over the years. Dysphagia 32:27\u201338. https:\/\/doi.org\/10.1007\/s00455-016-9775-x","journal-title":"Dysphagia"},{"issue":"5","key":"10005_CR16","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1111\/j.1749-4486.2006.01285.x","volume":"31","author":"AM Kelly","year":"2006","unstructured":"Kelly AM, Leslie P, Beale T, Payten C, Drinnan MJ (2006) Fibreoptic endoscopic evaluation of swallowing and videofluoroscopy: does examination type influence perception of pharyngeal residue severity? Clin Otolaryngol 31(5):425\u2013432. https:\/\/doi.org\/10.1111\/j.1749-4486.2006.01285.x","journal-title":"Clin Otolaryngol"},{"key":"10005_CR17","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1007\/s00455-019-10089-8","volume":"35","author":"JM Pisegna","year":"2020","unstructured":"Pisegna JM, Kaneoka A, Coster WJ, Leonard R, Langmore SE (2020) Residue ratings on FEES: trends for clinical application of residue measurement. Dysphagia 35:164\u2013172. https:\/\/doi.org\/10.1007\/s00455-019-10089-8","journal-title":"Dysphagia"},{"key":"10005_CR18","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1159\/000365006","volume":"65","author":"AS Kaneoka","year":"2013","unstructured":"Kaneoka AS, Langmore SE, Krisciunas GP et al (2013) The Boston Residue and Clearance Scale: preliminary reliability and validity testing. Folia Phoniatr Logop 65:312\u2013317. https:\/\/doi.org\/10.1159\/000365006","journal-title":"Folia Phoniatr Logop"},{"issue":"6","key":"10005_CR19","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1016\/j.acap.2020.12.007","volume":"21","author":"KM Collard","year":"2021","unstructured":"Collard KM, McCormick DP (2021) A nutritional comparison of cow\u2019s milk and alternative milk products. Acad Pediatr 21(6):1067\u20131069. https:\/\/doi.org\/10.1016\/j.acap.2020.12.007","journal-title":"Acad Pediatr"},{"issue":"4","key":"10005_CR20","doi-asserted-by":"publisher","first-page":"2320","DOI":"10.1080\/87559129.2021.1952421","volume":"39","author":"F Reyes-Jurado","year":"2021","unstructured":"Reyes-Jurado F, Soto-Reyes N, D\u00e1vila-Rodr\u00edguez M et al (2021) Plant-based milk alternatives: types, processes, benefits, and characteristics. Food Rev Int 39(4):2320\u20132351. https:\/\/doi.org\/10.1080\/87559129.2021.1952421","journal-title":"Food Rev Int"},{"key":"10005_CR21","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1007\/s00455-015-9631-4","volume":"30","author":"PD Neubauer","year":"2015","unstructured":"Neubauer PD, Rademaker AW, Leder SB (2015) The Yale Pharyngeal Residue Severity Rating Scale: an anatomically defined and image-based tool. Dysphagia 30:521\u2013528. https:\/\/doi.org\/10.1007\/s00455-015-9631-4","journal-title":"Dysphagia"},{"key":"10005_CR22","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/BF00417897","volume":"11","author":"JC Rosenbek","year":"1996","unstructured":"Rosenbek JC, Robbins J, Roecker EB, Coyle JL, Wood JL (1996) A penetration\u2013aspiration scale. Dysphagia 11:93\u201398. https:\/\/doi.org\/10.1007\/BF00417897","journal-title":"Dysphagia"},{"issue":"1","key":"10005_CR23","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1177\/0003489417747084","volume":"127","author":"SG Butler","year":"2018","unstructured":"Butler SG, Stuart A, Markley L, Feng X, Kritchevsky SB (2018) Aspiration as a function of age, sex, liquid type, bolus volume, and bolus delivery across the healthy adult life span. Ann Otol Rhinol Laryngol 127(1):21\u201332. https:\/\/doi.org\/10.1177\/0003489417747084","journal-title":"Ann Otol Rhinol Laryngol"}],"container-title":["European Archives of Oto-Rhino-Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-025-10005-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00405-025-10005-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-025-10005-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T01:51:33Z","timestamp":1773971493000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00405-025-10005-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10005"],"URL":"https:\/\/doi.org\/10.1007\/s00405-025-10005-x","relation":{},"ISSN":["0937-4477","1434-4726"],"issn-type":[{"value":"0937-4477","type":"print"},{"value":"1434-4726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]},"assertion":[{"value":"2 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}]}}