Characterizing Puree Bite Sizes in People with Normal and Disordered Swallowing: Predictors and Impact on Swallowing Safety and Efficiency during Flexible Endoscopic Evaluation of Swallowing

Median self-selected puree bite sizes for adults with and without dysphagia is 10-11 mL, with larger bites associated with more pharyngeal residue. Additionally, FEES appears to result in a significant reduction in typical bite sizes, limiting the ability to test natural self-selected sizes of puree food during FEES. Therefore, to better approximate real-world eating during FEES, clinicians should consider testing puree volumes of ∼10 mL as part of a standardized protocol.