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Penetration–Aspiration: Is Their Detection in FEES® Reliable Without Video Recording?

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Abstract

Penetration–aspiration is known as the main finding in deglutition-disordered patients with implications for diagnostics and therapeutic management. Reliable detection of penetration–aspiration is given with fiberoptic endoscopic evaluation of swallowing (FEES®) as one of the gold standards in instrumental swallowing evaluation. The advice to implement video recording in FEES® to assure quality in identifying penetration–aspiration is often ignored, especially in bed-side settings. Thus, the aim of this study was to compare reliability and validity in detecting penetration–aspiration events with and without video recording. Eighty FEES® sequences, ten per severity grade of the Penetration–Aspiration Scale by Rosenbek et al., were rated by four blinded ENTs with two different methods. The first method simulated the evaluation without video recording (Method A), and the second one with video recording (Method B). Rating was performed twice per setting with 2 weeks in between and every time newly randomized. Intra- and inter-rater reliability as well as validity were analyzed for both evaluation methods. R-to-Z transformation was used to reveal the more reliable method and ordinal regression to determine potential rating influences. Method B demonstrated higher intra- and inter-rater reliability values than Method A and was revealed as more reliable in identifying penetration–aspiration according to r-to-Z transformation (Z = −2.92, p = .004). Ordinal regression detected a significant influence of the evaluation method choice on the rating results (p = .016). As Method B turned out to be more reliable than Method A in detecting penetration–aspiration, the presented study recommends the implementation of video recording in swallowing diagnostics.

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Acknowledgments

The authors are thankful to Prof. J. C. Rosenbek for his helpful comments on the interpretation of the data in this research.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Phoniatrics and Pediatric Audiology, University of Frankfurt/Main, Theodor-Stern-Kai 7, House 7A, 60590, Frankfurt am Main, Germany

    Christiane Hey PhD, Petra Pluschinski, Raissa Pajunk, Anas Almahameed, Lara Girth & Yevgen Zaretsky

  2. Center of Surgery, Clinic for Oral, Dental and Cosmetic Facial Surgery, University of Frankfurt/Main, Theodor-Stern-Kai 7, House 28, 60590, Frankfurt am Main, Germany

    Robert Sader

  3. Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University of Frankfurt/Main, Theodor-Stern-Kai 7, House 8D, 60590, Frankfurt am Main, Germany

    Timo Stöver

Authors
  1. Christiane Hey PhD
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  2. Petra Pluschinski
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  3. Raissa Pajunk
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  4. Anas Almahameed
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  5. Lara Girth
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  6. Robert Sader
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  7. Timo Stöver
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  8. Yevgen Zaretsky
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Correspondence to Christiane Hey PhD.

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Hey, C., Pluschinski, P., Pajunk, R. et al. Penetration–Aspiration: Is Their Detection in FEES® Reliable Without Video Recording?. Dysphagia 30, 418–422 (2015). https://doi.org/10.1007/s00455-015-9616-3

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  • DOI: https://doi.org/10.1007/s00455-015-9616-3

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