Adding Endoscopist-Directed Flexible Endoscopic Evaluation of Swallowing to the Videofluoroscopic Swallowing Study Increased the Detection Rates of Penetration, Aspiration, and Pharyngeal Residue.
- Author:
Won Young PARK
1
;
Tae Hee LEE
;
Nam Seok HAM
;
Ji Woong PARK
;
Yang Gyun LEE
;
Sang Jin CHO
;
Joon Seong LEE
;
Su Jin HONG
;
Seong Ran JEON
;
Hyun Gun KIM
;
Joo Young CHO
;
Jin Oh KIM
;
Jun Hyung CHO
;
Ji Sung LEE
Author Information
- Publication Type:Original Article ; Evaluation Studies ; Research Support, Non-U.S. Gov't
- Keywords: Deglutition disorders; Endoscopy; Videofluoroscopic swallowing study
- MeSH: Aged; Deglutition/*physiology; Deglutition Disorders/*diagnosis/radiography; Female; Fluoroscopy/methods; Humans; Laryngoscopy/*methods/statistics & numerical data; Male; Middle Aged; *Pharynx/radiography; Reproducibility of Results; Retrospective Studies; Video Recording
- From:Gut and Liver 2015;9(5):623-628
- CountryRepublic of Korea
- Language:English
- Abstract: 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 (kappa=0.34; 95% confidence interval [CI], 0.15 to 0.53) and liquid food (kappa=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 (kappa=0.63; 95% CI, 0.41 to 0.94) and "fair" with liquid food (kappa=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.
