Fiber-optic endoscopic examination of swallowing in acnte stroke patients

Abstract

Objective To evaluate the clinical value of fiber-optic endoscopic examination of swallowing (FEES)in the diagnosis and treatment of dysphagia in acute stroke patients.Methods Ninety-five patients with acute stroke received FEES from April 2005 to December 2007.Aspiration,spillage,penetration and residue welre observed.The relation between aspiration during FEES and pneumonia post-stroke Was analyzed.Diet protocols were suggested according to the FEES results.Epistaxis,airway compromise and significant changes in heart rate or blood pressure before and after the examination were assessed to determine the safety of FEES.Patients were also asked to rate the level of discomfort of the examination.Results Of the 95 patients,45 exhibited spillage,34 had penetration,47 aspirated and 53 had residue.The patients with aspiration had a significantly higher incidence of pneumonia than those without aspiration(25.5%vs 0%).Based on the FEES findings,a normal diet was recommended for 34 of the patients,27 required compensatory management and 27 received nasogastric tube feeding.No such adverse effects as epistaxis,airway compromise or significant changes in heart rate or blood pressure were noted during the period of the study.Eighty-two patients reported no discomfort or mild discomfort during FEES.Conclusion FEES can be a valuable tool for evaluating and managing dysphagia in acute stroke patients. Key words: Swallowing disorders; Fiber-optic endoscopic examination; Stroke