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KMID : 1188320150090050623
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Gut and Liver
2015 Volume.9 No. 5 p.623 ~ p.628
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Adding Endoscopist-Directed Flexible Endoscopic Evaluation of Swallowing to the Videofluoroscopic Swallowing Study Increased the Detection Rates of Penetration, Aspiration, and Pharyngeal Residue
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Park Won-Young
Lee Tae-Hee
Ham Nam-Seok
Park Ji-Woong
Lee Yang-Gyun
Cho Sang-Jin
Lee Joon-Seong
Hong Su-Jin
Jeon Seong-Ran
Kim Hyun-Gun
Cho Joo-Young
Kim Jin-Oh
Cho Jun-Hyung
Lee Ji-Sung
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Abstract
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Background/Aims:Currently, the videofluoroscopic swallowing study (VFSS) is the standard tool for evaluating dysphagia. We evaluated whether the addition of endoscopist-directed flexible endoscopic evaluation of swallowing (FEES) to VFSS could improve the detection rates of penetration, aspiration, and pharyngeal residue, compared the diagnostic efficacy between VFSS and endoscopist-directed FEES and assessed the adverse events of the FEES.
Methods:In single tertiary referral center, a retrospective analysis of prospectively collected data was conducted. Fifty consecutive patients suspected of oropharyngeal dysphagia were enrolled in this study between January 2012 and July 2012.
Results:The agreement in the detection of penetration and aspiration between VFSS and FEES of viscous food (κ=0.34; 95% confidence interval [CI], 0.15 to 0.53) and liquid food (κ=0.22; 95% CI, 0.02 to 0.42) was “fair.” The agreement in the detection of pharyngeal residue between the two tests was “substantial” with viscous food (κ=0.63; 95% CI, 0.41 to 0.94) and “fair” with liquid food (κ=0.37; 95% CI, 0.10 to 0.63). Adding FEES to VFSS significantly increased the detection rates of penetration, aspiration, and pharyngeal residue. No severe adverse events were noted during FEES, except for two cases of epistaxis, which stopped spontaneously without requiring any packing.
Conclusions:This study demonstrated that the addition of endoscopist-directed FEES to VFSS increased the detection rates of penetration, aspiration, and pharyngeal residue
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KEYWORD
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Deglutition disorders, Endoscopy, Videofluoroscopic swallowing study
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