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Review
. 2007 Dec;27(6):306-16.

Role of videofluoroscopy in evaluation of neurologic dysphagia

M G Rugiu  1
Affiliations
Review

Role of videofluoroscopy in evaluation of neurologic dysphagia

M G Rugiu. Acta Otorhinolaryngol Ital. 2007 Dec.

Abstract
in English, Italian

For many years, videofluoroscopy was considered the gold standard for studies on swallowing disorders, and only recently has its role been challenged, due primarily to the widespread use of videoendoscopy in the evaluation of dysphagia. Albeit, videofluoroscopy still maintains its key role in this area and, in particular, in studies on dysphagia of neurological origin, on account not only of the possibility, with this procedure, to achieve complete and dynamic evaluation of all phases of deglutition, but also the high sensitivity and specificity in revealing the presence of inhalation. Aim of the present investigation was to analyse the technical procedure of videofluoroscopy and the principal indications in the study of dysphagia of neurological origin, in the attempt to reveal the advantages and disadvantages occurring in this examination, also with respect to other methods adopted in the evaluation of dyphagia. In conclusion, at present, no instrumental examination can be defined as ideal for the study of swallowing, but it can be seen that, with each of these procedures, the information forthcoming is actually complementary, thus achieving the aim to proceed as correctly and rapidly as possible, with the management of patients with dysphagia.

La videofluoroscopia è stata considerata per anni il gold standard per lo studio delle alterazioni della deglutizione. Solo recentemente il suo ruolo è stato messo in discussione, principalmente a causa della diffusione che ha trovato la videoendoscopia nella valutazione della disfagia. La videofluoroscopia mantiene comunque il suo ruolo chiave in questo campo ed in particolare nello studio della disfagia di origine neurologica, grazie soprattutto alla possibilità che essa offre di valutare in modo completo e dinamico tutte le fasi della deglutizione e alla sua alta sensibilità e specificità nell’evidenziare la presenza di inalazione. In questo lavoro saranno analizzate le modalità di esecuzione della videofluoroscopia e le sue principali indicazioni nello studio della disfagia di origine neurologica, nel tentativo di evidenziare vantaggi e svantaggi presentati da questo esame, anche in rapporto alle altre metodiche utilizzate nella valutazione della disfagia. In conclusione attualmente nessun esame strumentale può essere definito come ideale per lo studio della deglutizione, ma esiste piuttosto una complementarietà tra le informazioni fornite da ciascuno, nell’obiettivo di ottenere una corretta e precoce presa in carico del paziente affetto da disfagia.

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Figures

Fig. 1
Fig. 1
Lateral view of swallow during VFS, showing penetration of contrast medium above vocal cords.
Fig. 2
Fig. 2
Lateral view of swallow during VFS, showing penetration of contrast medium below vocal cords (inhalation).
Fig. 3
Fig. 3
Lateral view swallow during VFS, demonstrating pharyngeal residue in pyriform sinuses.
Fig. 4
Fig. 4
Antero-posterior view of swallow during VFS, showing asymmetrical residue in left pyriform sinus.
See this image and copyright information in PMC

References

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