Videofluoroscopic Assessment of Patients with Dysphagia

Eisenhuber, Edith; Schima, Wolfgang; Schober, Ewald; Pokieser, Peter; Stadler, Alfred; Scharitzer, Martina; Oschatz, Elisabeth

doi:10.2214/ajr.178.2.1780393

Cited by 173 publications

(75 citation statements)

References 22 publications

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“…The scale proposed by Paulon, that uses the barium line as a benchmark, was used for oral tongue, tongue base and posterior pharyngeal wall (23) . For quantification of stasis in the vallecula and pyriform sinus structures, the scale developed by Eisenhuber et al (24) was used. It considers the total height of the structure, with a discrete degree represented by less than 25% of the height of the structure; moderate degree greater than 25% but less than 50% and severe degree when stasis exceed 50% of the height of the structure.…”

Section: ) Stasismentioning

confidence: 99%

Associação entre os achados do questionário de disfagia M. D. Anderson e a videofluoroscopia da deglutição após tratamento do câncer de cabeça e pescoço

Andrade

Gonçalves

Guedes

et al. 2017

CoDAS

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RESUMO Introdução A utilização de questionários sintoma-específicos no câncer de cabeça e pescoço (CCP) em conjunto com avaliações objetivas da deglutição pode ser sensível às mudanças na qualidade de vida (QV) decorrentes da disfagia, porém é uma ferramenta pouco utilizada como complemento de avaliações clínicas. Objetivo analisar a associação entre o questionário de disfagia M. D. Anderson (MDADI) com a videofluoroscopia (VF) da deglutição em pacientes tratados do CCP. Método Estudo retrospectivo, com revisão de prontuários, dados da VF e do questionário de disfagia MDADI. Foram incluídos indivíduos maiores de 18 anos, tratados do câncer de cavidade oral, orofaringe, hipofaringe e laringe, independentemente do tratamento curativo. Para o exame de VF, foram consideradas as deglutições de 5 e 20 ml na consistência néctar. O teste não paramétrico de Mann-Whitney foi utilizado para avaliar a associação entre o questionário MDADI e a VF. Resultados Casuística de 39 indivíduos, predomínio de homens, 34 (87,18%), e média de idade de 61 anos. Prevalência de câncer de cavidade oral, 16 (41,03%). Vinte e dois (56,4%) possuíam estádio clínico IV. Cirurgia isolada foi o tratamento mais prevalente, 16 (41,03%). Vinte indivíduos (51,28%) se alimentavam por via oral. A média total (MT) do MDADI foi de 63,36. Na correlação da VF com o MDADI, observou-se associação significante entre MT, domínio emocional (DE) e domínio físico (DFis) com penetração para 5 ml. Penetração e aspiração com 20 ml determinou prejuízo para questão global (p=0,018 e p=0,0053), DE (p=0,0012 e p=0,027), DFis (p=0,0002 e p=0,0051) e MT (p=0,0023 e p=0,0299), respectivamente. A presença de estase não determinou piora da QV. Conclusão Pacientes tratados do CCP que apresentam penetração/aspiração demonstram impacto na qualidade de vida nos DE e DFis.

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Section: ) Stasismentioning

confidence: 99%

Associação entre os achados do questionário de disfagia M. D. Anderson e a videofluoroscopia da deglutição após tratamento do câncer de cabeça e pescoço

Andrade

Gonçalves

Guedes

et al. 2017

CoDAS

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“…The amounts of pharyngeal barium residue have also been shown to correlate with the incidence of aspiration and quantitative scintigraphy data 31, 32. Pharyngeal residue has also been reported to be the most important VFSS variable in reflecting pharyngeal pressure measurements in both diseased and healthy participants 33.…”

Section: Discussionmentioning

confidence: 95%

Swallowing markers in spinal and bulbar muscular atrophy

Banno

Katsuno

Suzuki

et al. 2017

Ann Clin Transl Neurol

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ObjectiveWe examined the characteristics of dysphagia in spinal and bulbar muscular atrophy, a hereditary neuromuscular disease causing weakness of limb, facial, and oropharyngeal muscles via a videofluoroscopic swallowing study, and investigated the plausibility of using these outcome measures for quantitative analysis.MethodsA videofluoroscopic swallowing study was performed on 111 consecutive patients with genetically confirmed spinal and bulbar muscular atrophy and 53 age‐ and sex‐matched healthy controls. Swallowing of 3‐mL liquid barium was analyzed by the Logemann's Videofluorographic Examination of Swallowing worksheet.ResultsOf more than 40 radiographic findings, the most pertinent abnormal findings in patients with spinal and bulbar muscular atrophy, included vallecular residue after swallow (residue just behind the tongue base), nasal penetration, and insufficient tongue movement (P < 0.001 for each) compared with healthy controls. Quantitative analyses showed that pharyngeal residue after initial swallowing, oral residue after initial swallowing, multiple swallowing sessions, and the penetration–aspiration scale were significantly worse in these patients (P ≤ 0.005 for each) than in controls. In patients with spinal and bulbar muscular atrophy, laryngeal penetration was observed more frequently in those without subjective dysphagia.InterpretationDysphagia of spinal and bulbar muscular atrophy was characterized by impaired tongue movement in the oral phase and nasal penetration followed by pharyngeal residues, which resulted in multiple swallowing sessions and laryngeal penetration. Although major limitations of reproducibility and radiation exposure still exist with videofluoroscopy, pharyngeal residue after initial swallowing and the penetration–aspiration scale might serve as potential outcome measures in clinical studies.

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“…Pharyngeal residue, the retention of food or liquid in the pharynx after swallowing, is a major sign of dysphagia caused by reduced movement or force of key muscles and structures that propel and clear the bolus through the oral and pharyngeal cavities [1,2]. Because pharyngeal residue can lead to a restricted diet, lack of adequate oral intake, aspiration, and a decrease in quality of life [2,3,4], it is important for clinicians to reliably and accurately measure residue severity.…”

Section: Introductionmentioning

confidence: 99%

“…Because pharyngeal residue can lead to a restricted diet, lack of adequate oral intake, aspiration, and a decrease in quality of life [2,3,4], it is important for clinicians to reliably and accurately measure residue severity.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Boston Residue and Clearance Scale: Preliminary Reliability and Validity Testing

Kaneoka

Langmore

Krisciunas

et al. 2013

Folia Phoniatr Logop

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Background: There is no appropriately validated scale with which to rate the problem of residue after swallowing. The Boston Residue and Clearance Scale (BRACS) was developed to meet this need. Initial reliability and validity were assessed. Methods: BRACS is an 11-point ordinal residue rating scale scoring three aspects of residue during a fiberoptic endoscopic evaluation of swallowing (FEES): (1) the amount and location of residue, (2) the presence of spontaneous clearing swallows, and (3) the effectiveness of clearing swallows. To determine inter-rater and test-retest reliability, 63 swallows from previously recorded FEES procedures were scored twice by 4 raters using (1) clinical judgment (none, mild, mild-moderate, moderate, moderate-severe, severe) and (2) BRACS. Concurrent validity was tested by correlating clinical judgment scores with BRACS scores. Internal consistency of the items in BRACS was examined. A factor analysis was performed to identify important factors that suggest grouping within the 12 location items in BRACS. Results: BRACS showed excellent inter-rater reliability (intraclass correlation coefficient, ICC = 0.81), test-retest reliability (ICC: 0.82-0.92), high concurrent validity (Pearson's r = 0.76), and high internal consistency (Cronbach's α = 0.86). Factor analysis revealed 3 main latent factors for the 12 location items. Conclusion: BRACS is a valid and reliable tool that can rate the severity of residue.

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Videofluoroscopic Assessment of Patients with Dysphagia

Cited by 173 publications

References 22 publications

Associação entre os achados do questionário de disfagia M. D. Anderson e a videofluoroscopia da deglutição após tratamento do câncer de cabeça e pescoço

Associação entre os achados do questionário de disfagia M. D. Anderson e a videofluoroscopia da deglutição após tratamento do câncer de cabeça e pescoço

Swallowing markers in spinal and bulbar muscular atrophy

The Boston Residue and Clearance Scale: Preliminary Reliability and Validity Testing

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