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Online edition:ISSN 2434-3404

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Fiberoptic endoscopic examination of swallowing (FEES) compared with videofluoroscopy (VF) in the evaluation of aspiration in stroke patients *

Fiberoptic endoscopic examination of swallowing (FEES) and videofluoroscopy (VF) were performed in 105 stroke patients who were receiving tube feeding because of suspected dysphagia. To confirm the clinical usefulness of FEES, we compared aspiration frequency observed by VF and the pharyngeal phase of swallowing function evaluated by FEES and examined the multiple regression analysis. Impaired laryngeal closure, impaired vocal cord mobility, impaired laryngeal mucosal sensation, aspiration (laryngeal penetration) by FEES, and pooling of secretion in the valleculae or pyriform sinuses were observed in 60 (93.8%), 26 (40.6%), 56 (87.5%), 62 (96.9%), and 59 (92.2%) of 64 patients with aspiration on VF, and in 3 (7.3%), 20 (48.8%), 1 (2.4%), 8 (19.5%) and 9 (22.0%) of 41 patients without aspiration on VF, respectively. Among FEES parameters, significant correlation with VF-detected aspiration was observed in impaired laryngeal closure, impaired laryngeal mucosal sensation, aspiration by FEES, and pooling of secretion in the pharynx. No correlation was found between impaired vocal cord mobility and VF-detected aspiration. The equation for prediction that was obtained by the multiple regression analysis by the use of evaluation scores for the FEES function as 1 for normal and 2 for abnormal, was [VF score] = 0.297 + 0.395 x [laryngeal closure score] -0.113 x [vocal cord mobility score] + 0.411 x [laryngeal mucosal sensation score] + 0.229 x [aspiration score by FEES] -0.478 x [pooling score of secretions] . The multiple correlation coefficient (R 2 = 0-819) was so high that VF-detected aspiration might be predicted to be estimated by the detail observations of FEES. It is suggested that FEES is as useful as VF for examination of the pharyngeal phase functions of swallowing, particularly for aspiration. FEES can be performed at the bedside, and the pharynx and larynx can be macroscopically observed safely. Therefore, FEES may be valuable for the evaluation in patients with dysphagia. (Accepted on Octobcr 22, 2001) Kawasaki Igakkaiski 27(4) : 323-330, 2001

Author
Ishii M.
Volume
27
Issue
4
Pages
323-330
DOI
10.11482/KMJ27(4)323-330.2001.pdf

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