Milk nasendoscopy in the assessment of dysphagia

Wilson, Patti; Hoare, T. J.; Johnson, April

doi:10.1017/s0022215100120043

Cited by 18 publications

(6 citation statements)

References 1 publication

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“…Although videofluoroscopy provides more comprehensive information about swallowing, including oral and esophageal phases, which cannot be assessed thoroughly in FEES, there are many practical reasons limiting its use and thus facilitating the preference of FEES (11) : patients who need to be evaluated without delay, patients who need to be examined repeatedly, patients who receive biofeedback training, patients who are bedridden or immobilized, patients who are in ICU or on monitors, patients who refuse more radiation exposure, and patients who aspirate easily. In these situations, FEES is safer, more accessible, and more efficient than videofluoroscopy because the equipment of FEES is portable and the testing materials are commercially available (liquid dye can be replaced with milk) (14) .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Swallowing Safety With Fiberoptic Endoscope: Comparison With Videofluoroscopic Technique

et al. 1997

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Videofluoroscopy has long been viewed as the "gold standard" of swallowing examination for the comprehensive information it provides. However, it is not very efficient and accessible in some practical situations. In this study, we tried to use a modified technique of fiberoptic endoscopic examination of swallowing (FEES) in evaluating dysphagic patients. For each examination, a spoonful of pudding and dyed water were fed in sequence three times. The pharyngeal swallowing events were observed with fiberscope panoramically and videotaped. Twenty-eight chronic dysphagic patients underwent both videofluoroscopy and FEES in 2 weeks. Comparison of the results revealed that disagreements in premature oral leakage to the pharynx, pharyngeal stasis, laryngeal penetration, aspiration, effective cough reflex, and velopharyngeal incompetence were 39.3%, 10.7%, 14.3%, 14.3%, 39.3%, and 32.1%, respectively. FEES was found to be more sensitive in detecting these risky features of swallowing, except with respect to premature leakage. Possible causes of the discrepant results are discussed, and the limitation of videofluoroscopy in practical usage is discussed. FEES is conclusively a safer, more efficient, and sensitive method than videofluoroscopy in evaluating swallowing safety.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Swallowing Safety With Fiberoptic Endoscope: Comparison With Videofluoroscopic Technique

et al. 1997

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“…Many authors consider this test as the one with the highest sensitivity and specificity for the diagnosis of oropharyngeal dysphagia and the detection of aspiration [38]. Later the FESS, was described by Langmore et al [39], and became largerly used in clinical practice by others [40][41][42], with results comparable to those obtained with the videofluoroscopy swallowing evaluation [43,44]. More recently, a modification of the FESS was proposed by Aviv et al [45], who included a sensory test.…”

Section: Methods To Diagnose Aspiration In Enterally Fed Patientsmentioning

confidence: 99%

The nasogastric feeding tube as a risk factor for aspiration and aspiration pneumonia

Gomes

Pisani²,

Macedo³

et al. 2003

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

138

101

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Sometimes it is possible to differentiate whether the aspirate is gastric or pharyngeal. The kind of bacterial contamination is, however, more difficult to establish. Oral or dental disease, antibiotic therapy, systemic illness or malnutrition and reduction of salivary flow are responsible for colonization of Gram-negative bacteria in oral and pharyngeal flora in nasogastric-tube-fed patients. The use of a nasogastric feeding tube and the administration of food increase gastric pH and lead to colonization of gastric secretions. It has also been suggested that gastric bacteria could migrate upward along the tube and colonize the pharynx.

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“…Langmore 7 and Bastian 5 pioneered the use of the flexible nasendoscope in the assessment of swallowing function. Wilson et al 8 used milk nasendoscopy in their assessment of dysphagia and in the detection of aspiration. Wu 9 found endoscopic assessment of swallowing to be safer, more efficient and sensitive than videofluoroscopy in evaluating swallowing safety.…”

mentioning

confidence: 99%

Comparison between videofluoroscopy and milk-swallow endoscopy in the assessment of swallowing function

Madden¹,

Fenton²,

Hughes³

et al. 2000

Clin Otolaryngol

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The investigation of swallowing function and the detection of aspiration has evolved over the past 10 years with the introduction of the fibreoptic endoscopic assessment. Practical reasons can limit the use of videofluoroscopy in some patients. A prospective study of 20 sets of videofluoroscopic and endoscopic assessments of swallowing function were compared. Endoscopic assessment was found to be a highly sensitive and specific method of determining swallowing safety. Reduced or absent laryngeal sensation at endoscopy correlates with silent aspiration and thus a high risk of aspiration pneumonia.

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Milk nasendoscopy in the assessment of dysphagia

Cited by 18 publications

References 1 publication

Evaluation of Swallowing Safety With Fiberoptic Endoscope: Comparison With Videofluoroscopic Technique

Evaluation of Swallowing Safety With Fiberoptic Endoscope: Comparison With Videofluoroscopic Technique

The nasogastric feeding tube as a risk factor for aspiration and aspiration pneumonia

Comparison between videofluoroscopy and milk-swallow endoscopy in the assessment of swallowing function

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