Back
 IJOHNS  Vol.5 No.4 , July 2016
Role of Fibreoptic Endoscopy in Evaluating Swallowing Disorders
Abstract: Objective: The objective is to assess patients complaining of dysphagia with fibreoptic endoscopic evaluation of swallowing [FEES]. Study design: It is a prospective study. Setting: The study is conducted at Tertiary referral hospital. Methods: In our study, twenty patients with complaints of dysphagia were evaluated with fibreoptic endoscopic evaluation of swallowing. Patients with pharyngeal cause of dysphagia were identified and recommended dietary modifications or positional manoeuvre. Results: A total of twenty patients were evaluated with FEES. Patients were categorised into two groups based on the etiological factor: neurological and non-neurological patients. In eleven of the neurological patients, premature spillage was seen in four patients. Pooling for solids was seen in one patient and for liquids in four patients, pooling for both solids and liquids was seen in six patients, penetration was seen in 1 patient and aspiration in one patient. All these patients were diagnosed to have a pharyngeal cause of dysphagia. In the nine of the non-neurological group, pooling of liquids was seen in four patients, and aspiration was seen in one patient. None of the patients of this group had spillage. One patent had penetration. Five patients had pharyngeal cause of dysphagia. Remaining four patients had normal study. These patients with pharyngeal cause were advised dietary modification or positional manoeuvre or a combination of both. Conclusion: FEES is an effective and valuable tool for evaluating pharyngeal dysphagia, and is helpful in guiding the patients for diet and rehabilitation. It is essential to assess the safety of swallowing in patients to prevent silent aspiration and aspiration pneumonia.
Cite this paper: Deenadayal, D. , Bommakanti, V. , Kumar, B. and Naeem, N. (2016) Role of Fibreoptic Endoscopy in Evaluating Swallowing Disorders. International Journal of Otolaryngology and Head & Neck Surgery, 5, 145-152. doi: 10.4236/ijohns.2016.54025.
References

[1]   Karkos, P.D., Papouliakos, S., Karkos, C.D. and Theochari, E.G. (2009) Current Evaluation of the Dysphagic Patient. Hippokratia, 13, 141-146.

[2]   Siebens, H., Trupe, E., Siebens, A., et al. (1986) Correlates and Consequences of Eating Dependency in Institutionalized Elderly. Journal of the American Geriatrics Society, 34, 192-198.
http://www.ncbi.nlm.nih.gov/pubmed/3950287
http://dx.doi.org/10.1111/j.1532-5415.1986.tb04202.x


[3]   Sang, Q. and Goyal, R.K. (2001) Swallowing Reflex and Brain Stem Neurons Activated by Superior Laryngeal Nerve Stimulation in the Mouse. American Journal of Physiology-Gastrointestinal and Liver Physiology, 280, G191-G200.
http://www.ncbi.nlm.nih.gov/pubmed/11208540

[4]   Logemann, J.A. (1986) Treatment for Aspiration Related to Dysphagia: An Overview. Dysphagia, 1, 34-38.
http://dx.doi.org/10.1007/BF02408238

[5]   Leder, S.B. (1998) Serial Fiberoptic Endoscopic Swallowing Evaluations in the Management of Patients with Dysphagia. Archives of Physical Medicine and Rehabilitation, 79, 1264-1269.
http://www.ncbi.nlm.nih.gov/pubmed/9779682
http://dx.doi.org/10.1016/S0003-9993(98)90273-8


[6]   Rugiu, M.G. (2007) Role of Videofluoroscopy in Evaluation of Neurologic Dysphagia. Acta Otorhinolaryngologica Italica, 27, 306-316.

[7]   Singh, S. and Hamdy, S. (2006) Dysphagia in Stroke Patients. Postgraduate Medical Journal, 82, 383-391.
http://dx.doi.org/10.1136/pgmj.2005.043281

[8]   Brady, S. and Donzelli, J. (2013) The Modified Barium Swallow and the Functional Endoscopic Evaluation of Swallowing. Otolaryngologic Clinics of North America, 46, 1009-1022.
http://dx.doi.org/10.1016/j.otc.2013.08.001

[9]   Nacci, A., Ursino, F., La Vela, R., Matteucci, F., Mallardi, V. and Fattori, B. (2008) Fiberoptic Endoscopic Evaluation of Swallowing (FEES): Proposal for Informed Consent. Acta Otorhinolaryngologica Italica, 28, 206-211.

[10]   Aviv, J.E., Kim, T., Thomson, J.E., Sunshine, S., Kaplan, S. and Close, L.G. (1998) Fiberoptic Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST) in Healthy Controls. Dysphagia, 13, 87-92.
http://www.ncbi.nlm.nih.gov/pubmed/9513302
http://dx.doi.org/10.1007/PL00009561


[11]   Kelly, A.M., Drinnan, M.J. and Leslie, P. (2007) Assessing Penetration and Aspiration: How Do Videofluoroscopy and Fiberoptic Endoscopic Evaluation of Swallowing Compare? Laryngoscope, 117, 1723-1727.
http://dx.doi.org/10.1097/MLG.0b013e318123ee6a

[12]   Ramsey, D., Smithard, D. and Kalra, L. (2005) Silent Aspiration: What Do We Know? Dysphagia, 20, 218-225.
http://dx.doi.org/10.1007/s00455-005-0018-9

[13]   Aviv, J.E., Murry, T., Zschommler, A., Cohen, M. and Gartner, C. (2005) Flexible Endoscopic Evaluation of Swallowing with Sensory Testing: Patient Characteristics and Analysis of Safety in 1340 Consecutive Examinations. Annals of Otology, Rhinology, and Laryngology, 114, 173-176.
http://www.ncbi.nlm.nih.gov/pubmed/15825564
http://dx.doi.org/10.1177/000348940511400301


[14]   Aviv, J.E., Kaplan, S.T., Thomson, J.E., Spitzer, J., Diamond, B. and Close, L.G. (2000) The Safety of Flexible Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST): An Analysis of 500 Consecutive Evaluations. Dysphagia, 15, 39-44.
http://www.ncbi.nlm.nih.gov/pubmed/10594257
http://dx.doi.org/10.1007/s004559910008


 
 
Top