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FEES für neurogene Dysphagien

Ausbildungscurriculum der Deutschen Gesellschaft für Neurologie und Deutschen Schlaganfall-Gesellschaft

FEES for neurogenic dysphagia

Training curriculum of the German Society of Neurology and the German Stroke Society

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Zusammenfassung

Die neurogene Dysphagie gehört zu den häufigsten und zugleich bedrohlichsten Symptomen einer Vielzahl neurologischer Erkrankungen, wie etwa dem Schlaganfall, den Parkinson-Syndromen und verschiedenen neuromuskulären Erkrankungen. Die flexible endoskopische Evaluation des Schluckakts (FEES) stellt heute in Deutschland die wahrscheinlich am häufigsten eingesetzte Methode zur objektiven Beurteilung des Schluckakts dar. Mithilfe der FEES werden die Effektivität und Sicherheit des Schluckakts beurteilt, geeignete Nahrungskonsistenzen bzw. Ernährungsformen festgelegt und der Einsatz von therapeutischen Manövern evaluiert. Aus der Datenlage geht zudem hervor, dass die FEES eine sehr gut verträgliche und sichere Untersuchung ist. Trotz des großen Bedarfs an qualifizierter Dysphagiediagnostik im klinischen Alltag wird diese Untersuchungstechnik bisher nicht systematisch vermittelt. Das in diesem Beitrag vorgestellte strukturierte Ausbildungscurriculum soll diese Lücke schließen und dazu beitragen, eine hohe FEES-Qualität sicherzustellen. Da das Dysphagiemanagement weit über das neurologische Fachgebiet hinausgeht, richtet sich dieses Curriculum auch an andere Mediziner, Logopäden, klinische Linguisten und Sprachtherapeuten mit spezieller Dysphagieexpertise.

Summary

Neurogenic dysphagia is one of the most frequent and prognostically relevant neurological deficits in a variety of disorders, such as stroke, parkinsonism and advanced neuromuscular diseases. Flexible endoscopic evaluation of swallowing (FEES) is now probably the most frequently used tool for objective dysphagia assessment in Germany. It allows evaluation of the efficacy and safety of swallowing, determination of appropriate feeding strategies and assessment of the efficacy of different swallowing manoeuvres. The literature furthermore indicates that FEES is a safe and well-tolerated procedure. In spite of the huge demand for qualified dysphagia diagnostics in neurology, a systematic FEES education has yet not been established. The structured training curriculum presented in this article aims to close this gap and intends to enforce a robust and qualified FEES service. As management of neurogenic dysphagia is not confined to neurologists, this educational program is applicable to other clinicians and speech language therapists with expertise in dysphagia as well.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. R. Dziewas wurde von den Firmen Covidien, Fresenius Kabi, Nestlé Healthcare Science, Rehder/Partner und Sanofi Aventis bei der Durchführung von Dysphagiefortbildungen unterstützt. T. Warnecke wurde von den Firmen Covidien, Fresenius Kabi, Nestlé Healthcare Science, Rehder/Partner, Sanofi Aventis, Abbvie, Teva und UCB bei der Durchführung von Dysphagiefortbildungen unterstützt. J. Glahn wurde von den Firmen AbbVie, Boehringer Ingelheim, Nutricia, Pentax und Storz bei der Durchführung von Dysphagiefortbildungen unterstützt. C. Helfer, G. Ickenstein, J. Keller, S. Lapa, C. Ledl, B. Lindner-Pfleghar, D. Nabavi, M. Prosiegel, A. Riecker, S. Stanschus, O. Busse geben an, dass kein Interessenkonflikt besteht. Der Beitrag enthält keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Allgemeine Neurologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48129, Münster, Deutschland

    R. Dziewas & T. Warnecke

  2. Neurologische Klinik, Johannes Wesling Klinikum, Minden, Deutschland

    J. Glahn

  3. Kliniken für HNO und Neurologie, Vivantes Klinikum Neukölln, Berlin, Deutschland

    C. Helfer

  4. Klinik für Neurologie und Stroke Unit, HELIOS Klinikum Aue, Aue, Deutschland

    G. Ickenstein

  5. Klinik für Akut-Geriatrie, St. Martinus-Krankenhaus, Düsseldorf, Deutschland

    J. Keller

  6. Klinik für Neurologie, ZNN, Universitätsklinikum Frankfurt a. M., Frankfurt a. M., Deutschland

    S. Lapa

  7. Schön Klinik Bad Aibling, Bad Aibling, Deutschland

    C. Ledl

  8. Klinik für Neurologie, Universitäts- und Rehabilitationsklinikum Ulm RKU, Ulm, Deutschland

    B. Lindner-Pfleghar & A. Riecker

  9. Klinik für Neurologie, Vivantes Klinikum Neukölln, Berlin, Deutschland

    D. Nabavi

  10. Deutsche interdisziplinäre Gesellschaft für Dysphagie, München, Deutschland

    M. Prosiegel

  11. Abteilung Logopädie und Schluckzentrum, Kreiskliniken Reutlingen, Reutlingen, Deutschland

    S. Stanschus

  12. Geschäftsstelle der DSG und DGN, Berlin, Deutschland

    O. Busse

Authors
  1. R. Dziewas
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  2. J. Glahn
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  3. C. Helfer
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  4. G. Ickenstein
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  5. J. Keller
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  6. S. Lapa
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  7. C. Ledl
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  8. B. Lindner-Pfleghar
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  9. D. Nabavi
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  10. M. Prosiegel
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  11. A. Riecker
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  12. S. Stanschus
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  13. T. Warnecke
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  14. O. Busse
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Corresponding author

Correspondence to R. Dziewas.

Additional information

R. Dziewas: Sprecher der FEES-AG der DGN und DSG.

J. Glahn: Vorsitzender der DSG-Kommission Pflegefortbildung auf der Stroke-Unit.

D. Nabavi: Vorsitzender der Stroke-Unit-Kommission der DSG.

O. Busse: Generalsekretär der DSG.

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Dziewas, R., Glahn, J., Helfer, C. et al. FEES für neurogene Dysphagien. Nervenarzt 85, 1006–1015 (2014). https://doi.org/10.1007/s00115-014-4114-7

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  • DOI: https://doi.org/10.1007/s00115-014-4114-7

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