The value of scintigraphy in the evaluation of oropharyngeal dysphagia

Argon, Murat; Seçıl, Yaprak; Duygun, Ülkem Yararbaş; Aydoğdu, İbrahim; Kocacelebi, Kenan; Özkılıç, Hayal; Ertekin, Çumhur

doi:10.1007/s00259-003-1276-0

Cited by 21 publications

(14 citation statements)

References 5 publications

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“…Oropharyngoesophageal scintigraphy (OPES) is well tolerated and useful for measuring transit times during the various swallowing phases and for assessing the percentage of bolus inhaled [5,[8][9][10]. OPES has confirmed its clinical validity in a functional and semiquantitative study of swallowing in patients with neurogenic dysphagia [19].…”

Section: Discussionmentioning

confidence: 99%

“…When radioactivity is detected in the larynx or in the tracheobronchial tract, the aspirated fraction can be calculated by dividing radioactive counts measured in the aspiration area (static acquisition) by radioactive counts measured in the oral cavity before swallowing is initiated [8,10].…”

Section: Scintigraphic Evaluationmentioning

confidence: 99%

“…On the other hand, oropharyngoesophageal scintigraphy (OPES) not only permits functional evaluation of swallowing, it also is used to obtain a detailed semiquantitative evaluation of the various stages of swallowing, especially data on transit time and retention of the bolus through the mouth, pharynx, and esophagus [5][6][7][8][9]. OPES also provides data on the fraction of the bolus aspirated into the tracheobronchial tract, if present [10].…”

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confidence: 99%

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Assessment of Swallowing by Oropharyngoesophageal Scintigraphy in Patients with Amyotrophic Lateral Sclerosis

et al. 2007

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Amyotrophic lateral sclerosis (ALS) is the most common degenerative motor neuron disease in adults, and dysphagia is one of its most frequent and disabling symptoms. Oropharyngoesophageal scintigraphy (OPES) permits a functional and semiquantitative study of the various stages of swallowing. We studied 28 ALS patients (12 females and 16 males; mean age = 63.57 +/- 10.39 yr SD), who were clinically rated against the ALSFRS scale (Amyotrophic Lateral Sclerosis Functioning Rating Scale) and underwent OPES with (99m)Tc-nanocolloid using either a liquid or a semisolid bolus. The semiquantitative parameters we analyzed were Oral Transit Time (OTT), Pharyngeal Transit Time (PTT), Esophageal Transit Time (ETT), Retention Index (RI), and Esophageal Emptying Rate (EER(10s)). Hence, the OPES performed with a semisolid bolus produced a higher proportion of pathologic values for the swallowing variables than when liquid bolus was used. Analyzed by grouping the patients into classes according to their bulbar ALSFRS scores, we found a significant increase in the OTT (p < 0.005), PTT (p < 0.02), and Oropharyngeal Retention Index (OPRI) (p < 0.0004) variables in ALS patients with more severe bulbar involvement. OPES has turned out to be a very important examination for detecting tracheal-bronchial inhalation and it also offers the possibility of acquiring a semiquantitative evaluation of the amount of food inhaled. In our experience, OPES in patients with ALS has been easy to use, economic, well tolerated, and capable of supplying precise indications with regard to the extent of the swallowing disorder, which permits a better clinical definition of the ALS patient.

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Section: Discussionmentioning

confidence: 99%

Section: Scintigraphic Evaluationmentioning

confidence: 99%

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confidence: 99%

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Assessment of Swallowing by Oropharyngoesophageal Scintigraphy in Patients with Amyotrophic Lateral Sclerosis

et al. 2007

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“…Scintigraphy in dysphagia mainly is used for detection of aspiration in young children because the radiation doses are less than those of videofluoroscopy [8]. It is used less frequently in adults, although recently it has been described as a useful and reliable diagnostic tool in adult patients with oropharyngeal dysphagia [9]. Only three studies have been performed with scintigraphy to examine pharyngeal parameters of normal swallowing physiology: Cook et al [10] used scintigraphy to study the influence of age on swallowing efficiency.…”

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confidence: 99%

Viscosity Is Not a Parameter of Postdeglutitive Pharyngeal Residue: Quantification and Analysis with Scintigraphy

et al. 2007

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Abstract. The aim of this study was to explore the influence of viscosity on pharyngeal residue in normal healthy volunteers. Scintigraphy was used to measure pharyngeal residue in 11 healthy volunteers after swallowing three different substances (age = 20.2-48.3 years). The first substance was a 10-ml solution of tap water with 0.5% xanthan with a viscosity of 4500 mPa s, comparable to a yogurt drink. The second and third substances were a 0.75% xanthan and a 1.00% xanthan solution, with viscosities of 10,500 and 21,000 mPa s, comparable to low-fat yogurt and 3% fat yogurt, respectively. Tap water was used as the control substance. Mean pharyngeal residue after swallowing tap water was 2.3% (SD = 1.2) of the initial volume in the oral cavity. Pharyngeal residue after swallowing 0.5% xanthan solution was 1.8% (SD = 0.8), after swallowing 0.75% xanthan solution 2.6% (SD = 2.2), and after swallowing 1.00% xanthan solution 2.8% (SD = 1.7). No significant correlation between increase of viscosity and pharyngeal residue was found. In healthy persons viscosity does not seem to be a significant parameter for pharyngeal residue for boluses with viscosities ranging from tap water to solutions having a viscosity comparable to 3% fat yogurt.Key words: Deglutition -Physiology -Radionuclide imaging -Deglutition disorders.The residual amount of food or beverage in the pharynx after swallowing (pharyngeal residue) is an important parameter in diagnostic procedures in the treatment of swallowing disorders. In common practice of management of swallowing disorders, the amount of pharyngeal residue is determined either by videofluoroscopy or by transnasal flexible endoscopy (FEES). With the help of logistic regression, Perlman et al.[1] predicted the chance of aspiration (food or liquid that gets into the lungs) based on the amount of pharyngeal residue. An odds ratio of 1.4 for aspiration was found for patients with pharyngeal residue. In this study 330 videofluoroscopies of dysphagic patients were analyzed and the amount of pharyngeal residue was rated on a four-point scale (absent, mild, moderate, severe). The study also showed that a patient with severe pharyngeal residue has an increased risk of aspiration (odds ratio of 4.0) and underlined the importance of quantifying pharyngeal residues. Dejaeger et al. [2] analyzed videofluoroscopies of 25 healthy elderly and clearly described localization of pharyngeal residue; unfortunately, they did not attempt to quantify the amount of residue.Few attempts have been made to quantify pharyngeal residue in normal and dysphagic populations, mainly because of the limited availability of appropriate diagnostic tools. Videofluoroscopy or FEES has been used to explore physiologic parameters of swallowing [3,4]. One of the limitations of the use of these techniques is the lack of reliable interpretation of physiologic parameters. Stoeckli et al. [5] analyzed the inter-and intrajudge reproducibility of the interpretation of videofluoroscopy and suggested that the agreement for assessing pharyn...

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“…While VFS is still considered by speech-language pathologists to be the gold standard, there are numerous reports in the literature that emphasise the validity of the other two methods 1 - 5 . Accurate assessment of the oro-pharyngeal phase of swallowing is particularly important since this presents the greatest clinical risk for dysphagic patients: tracheo-bronchial aspiration.…”

Section: Introductionmentioning

confidence: 99%

Acta Otorhinolaryngologica Italica

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Giusti

Mancini

et al. 2016

Acta Otorhinolaryngol Ital

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L’obiettivo di questo studio era quello di confrontare la Videofluoroscopia (VFS), la valutazione endoscopica a fibre ottiche della deglutizione (FEES) e la scintigrafia oro-faringo-esofagea (OPES) per quanto riguarda la caduta pre-deglutitoria, il ristagno post-deglutitorio e l’aspirazione, al fine di valutare l’attendibilità di questi test nel rilevare la disfagia orofaringea. Sessanta pazienti, affetti da disfagia di varia origine, sono stati arruolati nello studio e sottoposti a VFS, FEES e OPES utilizzando un bolo liquido e uno semi-solido. Abbiamo usato la VFS come esame di riferimento. La FEES e la OPES hanno entrambe mostrato una buona sensibilità, con valori complessivi elevati (rispettivamente ≥ 80% e ≥ 90%). Il confronto tra FEES e VFS relativamente alla caduta pre-deglutitoria ha evidenziato una buona specificità (84,4% per i semi-solidi e 86,7% per i liquidi). Nel caso di ristagni post-deglutitori, il confronto tra FEES e VFS ha rivelato una buona validità complessiva (75% per i semi-solidi), con specificità e sensibilità ben equilibrate per i semi-solidi. Il confronto tra OPES e VFS ha dimostrato buona sensibilità (88,6%) e validità complessiva (76,7%) per i liquidi. Il confronto dei dati ottenuti tra FEES e VFS, relativamente all’ aspirazione, ha evidenziato una bassa validità complessiva (≤ 65%). D’altra parte, la OPES ha mostrato una validità complessiva apprezzabile (71,7%). VFS, FEES e OPES sono in grado di rilevare la disfagia oro-faringea. La FEES ha fornito risultati significativi nella valutazione dei ristagni post-deglutitori.

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The value of scintigraphy in the evaluation of oropharyngeal dysphagia

Cited by 21 publications

References 5 publications

Assessment of Swallowing by Oropharyngoesophageal Scintigraphy in Patients with Amyotrophic Lateral Sclerosis

Assessment of Swallowing by Oropharyngoesophageal Scintigraphy in Patients with Amyotrophic Lateral Sclerosis

Viscosity Is Not a Parameter of Postdeglutitive Pharyngeal Residue: Quantification and Analysis with Scintigraphy

Acta Otorhinolaryngologica Italica

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