Gut Liver.
2015 Sep;9(5):623-628. 10.5009/gnl14147.
Adding Endoscopist-Directed Flexible Endoscopic Evaluation of Swallowing to the Videofluoroscopic Swallowing Study Increased the Detection Rates of Penetration, Aspiration, and Pharyngeal Residue
- Affiliations
-
- 1Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, Seoul, Korea. iman0825@naver.com
- 2Department of Physical Medicine and Rehabilitation, Soonchunhyang University College of Medicine, Seoul, Korea.
- 3Biostatistical Consulting Unit, Soonchunhyang University College of Medicine, Seoul, Korea.
- KMID: 2234068
- DOI: http://doi.org/10.5009/gnl14147
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.
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