Application of fibreoptic endoscope in evaluation of swallowing

Abstract

To investigate the effect of fibreoptic endoscopic evaluation of swallowing (FEES) in the assessment of dysphagia. Fifty-two patients with neurogenic dysphagia underwent FEES and videofluoroscopy (VF) within a 2-day period. The results obtained were compared. FEES with all consistencies revealed premature leakage in 48.1%, pooling in 75.0%, penetration in 69.2%, and aspiration in 55.8%, silent aspiration in 28.8% of patients. VF revealed above items in 44.2%, 63.5%, 57.7%, 46.2%, 21.2%, respectively. The FEES was then measured against the VF for sensitivity, specificity, positive predictive value, and negative predictive value. FEES showed higher sensibility and negative coincidence rate of penetration (90.0%, 81.3%), aspiration (87.5%, 87.0%) and silent aspiration (90.9%, 97.3%). According to the severity, the dysphagia in patients was classified into no penetration, penetration, aspiration and silent aspiration. A weighted Kappa value of 0.713 signified "substantial" agreement between the two tests. FEES is an effective and valuable tool for evaluating oropharyngeal dysphagia, and is helpful in guiding the patients for diet and rehabilitation.