Oropharyngeal findings of endoscopic examination in swallowing disorders of neurological origin

Abstract

A study was carried out to examine the significance of anatomical and functional oropharyngeal findings in patients with neurological disorders as part of an endoscopic evaluation of swallowing. The study included 101 patients (60.2 years+/-16.35, 63 male=62%, 38 female=38%) with neurological disorders (cerebral infarct, head injury, hypoxia) presenting with dysphagia. Oropharyngeal findings from endoscopic examination of nine anatomical regions and ten functional tests were correlated with the results of a standardised endoscopic swallowing test. Anatomical changes were obtained in 30 (30%) patients; functional changes were obtained in 67 (66%) patients. No correlation between these changes and swallowing ability was found. "Start of swallow," "leaking," "residues" and "follow-up swallowing" did show a correlation with the results of the swallowing test. In addition, for swallowing tests with saliva, "follow-up swallowing" and "swallowing after coughing" also showed a correlation. Anatomical or functional endoscopic oropharyngeal examination changes alone did not influence swallowing ability in the mixed neurological group studied. Evaluation of swallowing ability requires a swallowing test with saliva and various test consistencies under normal conditions. Failure to swallow following coughing during swallowing tests with saliva can be used as a clinical indicator for aspiration.