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Dysphagia

, Volume 29, Issue 1, pp 33–43 | Cite as

Effects of Topical Nasal Anesthetic on Fiberoptic Endoscopic Examination of Swallowing with Sensory Testing (FEESST)

  • Erin E. Kamarunas
  • Gary H. McCullough
  • Tiffany J. Guidry
  • Mark Mennemeier
  • Keith Schluterman
Original Article

Abstract

Objections to the use of topical nasal anesthesia (TNA) during fiberoptic endoscopic evaluation of swallowing (FEES) with sensory testing (FEESST) have been raised, primarily because of the possibility of desensitizing the pharyngeal and laryngeal mucosa and affecting both the sensory and motor aspects of the swallow. Furthermore, it has been suggested that TNA is not necessary during FEES as it does not improve patient comfort or make the procedure easier for the endoscopist. The purpose of this double-blind, randomized, controlled, crossover clinical trial was to determine how gel TNA during flexible endoscopic evaluation of swallowing with sensory testing affects sensation, swallowing, and comfort rating scores in healthy nondysphagic participants. Laryngopharyngeal sensory thresholds and swallowing durations were compared between two conditions: TNA and sham. Transition duration decreased statistically significantly during the TNA condition compared to the sham for 10 ml only (p < 0.05). All other swallowing measures did not change between the conditions. Laryngopharyngeal sensory thresholds and perceptions did not change between conditions. No change was observed for subject comfort scores, ease of exam, or quality of view. Future studies should evaluate TNA administration variables, including concentration, dosage amount, and method of application, to determine the optimal strategy for providing comfort while avoiding altered swallowing.

Keywords

Topical nasal anesthesia FEESST FEES 

Notes

Acknowledgments

This study was supported in whole by NIH/NINDS R21 HD055677 and in part by NICHHD HD055269, NCRR RR20146, DC011824, GM103425, and UL1TR000039.

Disclosures

The authors have no conflicts of interest to disclose.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Erin E. Kamarunas
    • 1
    • 2
  • Gary H. McCullough
    • 3
  • Tiffany J. Guidry
    • 4
  • Mark Mennemeier
    • 4
  • Keith Schluterman
    • 5
  1. 1.Department of Audiology and Speech PathologyUniversity of Arkansas for Medical SciencesLittle RockUSA
  2. 2.Arkansas Consortium for the Ph.D. in Communication SciencesLittle RockUSA
  3. 3.Department of Speech-Language PathologyUniversity of Central ArkansasConwayUSA
  4. 4.Department of Neurobiology and Developmental SciencesUniversity of Arkansas for Medical SciencesLittle RockUSA
  5. 5.Department of NeurologyConway Regional HospitalConwayUSA

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