James L. Coyle on Kagel

Marion Kagel, in the late 80’s and 90’s, described a tactic in which thermal (cold) gustatory (taste) stimulation was used to treat dysphagia. I believe they presented some of this data at the first of second DRS meeting in Milwaukee. It spawned the use of Italian lemon ice in the management of dysphagia. I still see the stuff in the freezers of the nursing units of some of the sites in which I see patients. I don’t know if they published their results.

Logemann et al. (1995) looked at the sour bolus effects on swallowing and others have investigated the combined effects of thermal, gustatory, and tactile/mechanical stimulation on swallowing (Sciortino, Liss, Case, Gerritsen, & Katz, 2003) using different methods and reporting varying degrees of effects on different outcomes. I’m almost certain others have looked at these things too. Logemann’s group flavored barium with a sour taste (lemon juice I think) for MBS swallows with and without the sour bolus, in dysphagic patients, and analyzed the traditionally measured biomechanical swallow variables. Sciortino’s group injected water into the mouths of normals after stimulating the faucial pillars (anterior) with the various combinations of thermal, tactile/mechanical, and taste stimuli.

James L. Coyle

University of Pittsburgh

Reference List

Logemann, J. A., Pauloski, B. R., Colangelo, L., Lazarus, C., Fujiu, M., & Kahrilas, P. J. (1995). Effect of a sour bolus on oropharyngeal swallowing measures in patients with neurogenic dysphagia. Journal of Speech and Hearing Research, 38, 556-563.

Sciortino, K., Liss, J. M., Case, J. L., Gerritsen, K. G., & Katz, R. C. (2003). Effects of mechanical, cold, gustatory, and combined stimulation to the human anterior faucial pillars. Dysphagia, 18, 16-26.