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Comparative Study
. 2016 Oct;36(5):395-402.
doi: 10.14639/0392-100X-829.

Comparison between videofluoroscopy, fiberoptic endoscopy and scintigraphy for diagnosis of oro-pharyngeal dysphagia

B Fattori  1 , P Giusti  2 , V Mancini  1 , M Grosso  3 , M R Barillari  4 , L Bastiani  5 , S Molinaro  5 , A Nacci  1
Affiliations
Comparative Study

Comparison between videofluoroscopy, fiberoptic endoscopy and scintigraphy for diagnosis of oro-pharyngeal dysphagia

B Fattori et al. Acta Otorhinolaryngol Ital. 2016 Oct.

Abstract
in English, Italian

The purpose of this study was to compare videofluoroscopy (VFS), fiberoptic endoscopic evaluation of swallowing (FEES) and oro-pharyngo- oesophageal scintigraphy (OPES) with regards to premature spillage, post-swallowing residue and aspiration to assess the reliability of these tests for detection of oro-pharyngeal dysphagia. Sixty patients affected with dysphagia of various origin were enrolled in the study and submitted to VFS, FEES and OPES using a liquid and semi-solid bolus. As a reference, we used VFS. Both the FEES and the OPES showed good sensitivity with high overall values (≥ 80% and ≥ 90% respectively). The comparison between FEES vs VFS concerning drop before swallowing showed good specificity (84.4% for semi-solids and 86.7% for liquids). In the case of post-swallowing residue, FEES vs VFS revealed good overall validity (75% for semi-solids) with specificity and sensitivity well balanced for the semi-solids. OPES vs. VFS demonstrated good sensitivity (88.6%) and overall validity (76.7%) for liquids. The analysis of FEES vs. VFS for aspiration showed that the overall validity was low (≤ 65%). On the other hand, OPES demonstrated appreciable overall validity (71.7%). VFS, FEES and OPES are capable of detecting oro-pharyngeal dysphagia. FEES gave significant results in the evaluation of post-swallowing residues.

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.

Keywords: Dysphagia; Fiberoptic Endoscopic Evaluation of Swallowing; Oro-pharyngo-oesophageal Scintigraphy; Speech-language pathology; Videofluoroscopy.

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