Nyáltermelésünk folyamatos, a szájüregben összegyűlt nyálat rendszeresen nyeljük. A páciens váladékkezelési képessége ezért nyilvánvaló változónak tűnik a nyelési zavar megítélésében. Ennek ellenére még a validált, betegágy melletti felmérésekben is különböző formában és hangsúllyal jelenik meg. Irodalmi áttekintésünkben ezt a jelenséget, amelyet a szakirodalom nyálnyelésként vagy száraz nyelésként ismer, a ’state-of-the-art’ típusú irodalmi áttekintés módszertanával vizsgáltuk. Azokra a kérdésekre kerestük a választ, hogy hogyan írható le a száraz nyelés élettana, van-e olyan neuroanatómiai jellegzetessége, amely megkülönbözteti a táplálkozási célú nyeléstől. Továbbá milyen validált száraznyelés-vizsgálatok vannak a dysphagia/aspiratio szűrésében, amelyeket a hazai gyakorlatban is biztonsággal alkalmazhatunk? Vannak-e kifejezetten száraznyelés-vizsgálati protokollok, létezik-e egységes gyakorlat? Dolgozatunk eredményeként olyan alapelveket fogalmaztunk meg, amelyek több betegcsoportra is általánosíthatók, közvetlen gyakorlati hasznát vehetik a felnőtt betegpopuláció nyelészavar-ellátását végző szakemberek, és új kutatási területeket is kínálhatnak. A betegvizsgálat során figyelembe kell venni a spontán nyelési gyakoriságot. Spontán nyelési esemény hiányában stimulációval kell megkísérelni a nyálnyelés kiváltását, majd csak ezt követően történjen a felszólításra végrehajtott száraznyelés-teszt. Csak a nyálnyelés megfigyelését követően történjen nyelésvizsgálat különböző konzisztenciákkal. A nyálnyelési eredményeket mindig további, nyelészavarra utaló változókkal együtt javasolt értelmezni. Orv Hetil. 2024; 165(12): 443–454.
Our saliva production is continuous, and we regularly swallow the saliva that accumulates in the oral cavity. The patient’s ability to manage secretions therefore seems to be an obvious variable in the assessment of a swallowing disorder. Nevertheless, even in validated bedside surveys, it appears in different forms and with different emphasis. In our literature review, we investigated this phenomenon, known in the literature as saliva swallowing or dry swallowing, using a state-of-the-art literature review methodology. We sought to answer the questions of how the physiology of dry swallowing can be described and whether it has neuroanatomical features that distinguish it from nutritional swallowing. Furthermore, what validated dry swallowing tests are available for dysphagia screening that can be safely used in national practice? Are there specific protocols for dry swallow testing? Is there a relevant standard practice? As a result of our thesis, we have formulated principles that can be generalized to several patient groups, it can be of direct practical use to professionals managing adult patient populations with dysphagia and it may offer new areas of research. Spontaneous swallowing frequency should be taken into account during patient assessment. In the absence of a spontaneous swallowing event, stimulation should be attempted to induce salivation, followed only by a dry swallow test on demand. Only after observation of salivation should a swallow test be performed with different consistencies. It is always recommended that dry swallowing results should be interpreted in the context of other variables indicative of dysphagia. Orv Hetil. 2024; 165(12): 443–454.
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