Adding Endoscopist-Directed Flexible Endoscopic Evaluation of Swallowing to the Videofluoroscopic Swallowing Study Increased the Detection Rates of Penetration, Aspiration, and Pharyngeal Residue

• Published in: Gut and liver 2015, 9(5), , pp.623-628
• Main Authors: 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
• Format: Article
• Language: English
• Subjects: Aged; Deglutition - physiology; deglutition disorders; Deglutition Disorders - diagnosis; Deglutition Disorders - diagnostic imaging; endoscopy; Female; Fluoroscopy - methods; Humans; Laryngoscopy - methods; Laryngoscopy - statistics & numerical data; Male; Middle Aged; Original; Pharynx - diagnostic imaging; Reproducibility of Results; Retrospective Studies; videofluoroscopic swallowing study; 내과학
• ISSN: 1976-2283; 2005-1212
• DOI: 10.5009/gnl14147

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. 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. 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. This study demonstrated that the addition of endoscopist-directed FEES to VFSS increased the detection rates of penetration, aspiration, and pharyngeal residue.