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Radiographic evaluation of complex dysphagic patients: Comparison with videoendoscopic technique

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Abstract

Swallowing is a highly coordinated sequence of physiologic events. Many disease processes affect the patient’s ability to have a functional swallow. The traditional videofluoroscopic swallowing study is an effective and established method for evaluating these patients and is the current examination of choice. Videoendoscopic evaluation is a safe and affordable procedure that can be used in an outpatient or office setting. It can also be a complementary technique, allowing direct visualization of pharyngeal structures and aspiration. We discuss the use of both techniques.

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References and Recommended Reading

  1. Elliott JL: Swallowing disorders in the elderly: a guide to diagnostic and treatment. Geriatrics 1988, 43:95–113.

    PubMed  CAS  Google Scholar 

  2. Groher ME, McKaig TN: Dysphagia and dietary levels in skilled nursing facilities. J Am Geriatr Soc 1995, 43:528–532.

    PubMed  CAS  Google Scholar 

  3. Talley NJ, Weaver AL, Zinsmeister AR, Melton LJ: Onset and disappearance of gastrointestinal symptoms and functional gastrointestinal disorders. Am J Epidemiol 1991, 136:165–177.

    Google Scholar 

  4. Daniels SK, McAdam CP, Brailey K, Foundas AL: Clinical assessment of swallowing and prediction of dysphagia severity. Am J Speech Lang Pathol 1997, 6:17–24.

    Google Scholar 

  5. Daniels SK, Brailey K, Priestly DH, et al.: Aspiration in patients with acute stroke. Arch Phys Med Rehab 1998, 79:14–19.

    Article  CAS  Google Scholar 

  6. Kidd D, Lawson L, Nesbitt R, MacMahon J: Aspiration in acute stroke: a clinical study with videofluoroscopy. QJM 1993, 86:825–829.

    PubMed  CAS  Google Scholar 

  7. Shaker R: Oropharyngeal dysphagia: practical approach to diagnosis and management. Semin Gastrointest Dis 1992, 3:115–128.

    Google Scholar 

  8. Dodds WJ, Stewart ET, Logemann JA: Physiology and radiology of the normal oral and pharyngeal phases of swallowing. AJR Am J Roentgenol 1990, 154:953–963.

    PubMed  CAS  Google Scholar 

  9. Dodds WJ, Logemann JA, Stewart ET: Radiologic assessment of abnormal oral and pharyngeal phases of swallowing. AJR Am J Roentgenol 1990, 154:965–974.

    PubMed  CAS  Google Scholar 

  10. Broniatowski M, Sonies BC, Rubin JS, et al.: Current evaluation and treatment of patients with swallowing disorders. Otolaryngol Head Neck Surg 1999, 120:464–473. A thorough review of normal swallowing, pathophysiology, management, and surgical therapy for oropharyngeal dysphagia.

    Article  PubMed  CAS  Google Scholar 

  11. Martin-Harris B, Logemann JA, McMahon S, Schleicher M: Clinical utility of the modified barium swallow. Dysphagia 2000, 15:136–141. The authors evaluate the immediate and clinically relevant information gained from a modified barium swallow and determine its impact on patient management.

    PubMed  CAS  Google Scholar 

  12. Dua KS, Easterling CS, Stewart ET: Esophagus. In Advances in Radiology of the Alimentary Tube. Edited by Margulis AR. Berlin: Springer-Verlag; 1998:73–93.

    Google Scholar 

  13. American College of Radiology: Radiation Risk — A Primer. Reston, VA: 1996; Appendix, 69.

  14. Jones B: Functional abnormalities of the pharynx. In Textbook of Gastrointestinal Radiology. Edited by Gore RM, Levine MS. St. Louis: WB Saunders; 2000:212–226. The most complete and current reference text on gastrointestinal radiology.

    Google Scholar 

  15. Bevan K, Griffiths MC: Chronic aspiration and laryngeal competence. J Laryngol Otol 1989, 103:196–199.

    PubMed  CAS  Google Scholar 

  16. Shaker R, Bowser M, Hogan WJ, et al.: Videoendoscopic characterization of abnormalities in pharyngeal phase of swallowing [abstract]. Gastroenterology 1991, 100:A494.

    Google Scholar 

  17. Shaker R, Martin B, Dodds WJ, et al.: Comparison of videoendoscopic and videofluoroscopoic evaluation of patients with cervical dysphagia [abstract]. Gastrointest Endosc 1991, 37:277.

    Google Scholar 

  18. Bastian RW: Videoendoscopic evaluation of patients with dysphagia: an adjunct to the modified barium swallow. Otolaryngol Head Neck Surg 1991, 104:339–350.

    PubMed  CAS  Google Scholar 

  19. Langmore SE, Schatz KI, Olson N: Endoscopic and videofluoroscopic evaluations of swallowing and aspiration. Ann Otol Rhinol Laryngol 1991, 100:678–681.

    PubMed  CAS  Google Scholar 

  20. Langmore SE, Schatz K, Olsen N: Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 1988, 2:216–219.

    Article  PubMed  CAS  Google Scholar 

  21. Saeian K, Shaker R: Oropharyngeal dysphagia. Curr Treat Options Gastroenterol 2000, 3:77–87.

    Google Scholar 

  22. Aviv JE, Martin JH, Keen MS, et al.: Air pulse quantification of supraglottic and pharyngeal sensation: a new technique. Ann Otol Rhinol Laryngol 1993, 102:777–780.

    PubMed  CAS  Google Scholar 

  23. Aviv JE, Martin JH, Kim T, et al.: Laryngopharyngeal sensory discrimination testing and the laryngeal adductor reflex. Ann Otol Rhinol Laryngol 1999, 108:725–730. This prospective nonrandomized study evaluates the use of videoendoscopy to determine the presence or absence of the laryngeal adductor reflex by stimulating the pharyngeal mucosa with a puff of air, to evaluate the laryngopharyngeal sensory response.

    PubMed  CAS  Google Scholar 

  24. Aviv JE: Clinical assessment of pharyngogolaryngeal sensitivity. Am J Med 2000, 108:68S-72S. This nonrandomized prospective clinical trial used an endoscopically delivered air pulse stimulation to the pharyngeal and laryngeal mucosa to assess sensitivity. Absence of laryngopharyngeal sensation was a significant predictor of aspiration pneumonia in the stroke group. Ease of use and availability of the videoendoscopic modality is discussed for both evaluation of dysphagia and prediction of aspiration.

    Article  PubMed  Google Scholar 

  25. Setzen M, Cohen MA, Mattucci KF, et al.: Laryngopharyngeal sensory deficits as a predictor of aspiration. Otolaryngol Head Neck Surg 2001, 124:622–624. This prospective clinical study determined that a lack of pharyngeal sensation and motor function is a predictor of aspiration; the investigators also found a correlation between hypopharyngeal sensory defecits and pharyngeal motor deficits.

    Article  PubMed  CAS  Google Scholar 

  26. Staff D, Shaker R: Aging in the gastrointestinal tract. Dis Mon 2001, 47:72–101.

    Article  PubMed  CAS  Google Scholar 

  27. Scott A, Perry A, Bench J: A study of interrater reliability when using videofluoroscopy as an assessment of swallowing. Dysphagia 1998, 13:223–227.

    Article  PubMed  CAS  Google Scholar 

  28. Kuhlemeier KV, Yates P, Palmer JB: Intra-and interrater variation in the evaluation of videofluorographic swallowing studies. Dysphagia 1998, 13:142–147.

    Article  PubMed  CAS  Google Scholar 

  29. Logemann JA, Rademaker AW, Pauloski BR, et al.: Normal swallowing physiology as viewed by videofluoroscopy and videoendoscopy. Folia Phoniatr Logop 1998, 50:311–319.

    Article  PubMed  CAS  Google Scholar 

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Spinelli, K.S., Easterling, C.S. & Shaker, R. Radiographic evaluation of complex dysphagic patients: Comparison with videoendoscopic technique. Curr Gastroenterol Rep 4, 187–192 (2002). https://doi.org/10.1007/s11894-002-0061-8

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