Correlations between Aspiration and Pharyngeal Residue Scale Scores for Fiberoptic Endoscopic Evaluation and Videofluoroscopy
10.3349/ymj.2019.60.12.1181
- Author:
Jin A YOON
1
;
Sang Hun KIM
;
Myung Hun JANG
;
Sung Dong KIM
;
Yong Beom SHIN
Author Information
1. Department of Rehabilitation Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. yi0314@gmail.com
- Publication Type:Original Article
- Keywords:
Deglutition;
deglutition disorders;
vocal cord dysfunction;
endoscopes;
fluoroscopy
- MeSH:
Deglutition;
Deglutition Disorders;
Endoscopes;
Fees and Charges;
Fluoroscopy;
Humans;
Phonation;
Pyriform Sinus;
Vocal Cord Dysfunction;
Vocal Cords;
Weights and Measures
- From:Yonsei Medical Journal
2019;60(12):1181-1186
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To examine correlations among rating scales and findings suggestive of tracheal aspiration and pharyngeal residue between fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallowing study (VFSS) in dysphagia patients. MATERIALS AND METHODS: We studied patients referred to our hospital for dysphagia assessment. Three raters judged the residue severity and laryngeal penetration or tracheal aspiration of FEES and VFSS. The raters applied the Penetration-Aspiration Scale (PAS) for tracheal aspiration and pixel-based circumscribed area ratio and Yale Pharyngeal Residue Severity for post-swallow residue in VFSS and FEES, respectively. Anatomy-physiologic findings during FEES associated with tracheal aspiration were also analyzed. RESULTS: A total of 178 participants were enrolled in our study. In correlation analysis, PAS (r=0.74), vallecula retention (r=0.76), and pyriform sinus retention (r=0.78) showed strong positive correlations between FEES and VFSS. Intra-rater agreement between VFSS and FEES was good for PAS (κ=0.65) and vallecula (κ=0.65) and pyriform sinus retention (κ=0.69). Among 72 patients who showed subglottic shelf residue, a suspected finding of aspiration, in FEES, 68 had concomitant tracheal aspiration during VFSS. Both vocal fold hypomobility and glottic gap during phonation were significantly associated with findings suggestive of tracheal aspiration during FEES (p<0.05). CONCLUSION: Quantitative and reliable aspiration and post swallow residue rating scales showed strong positive correlations and good agreement between VFSS and FEES.
