Abstract
Objectives
To clarify the reliability of fiberoptic endoscopic evaluation of swallowing (FEES)
compared to videofluoroscopic swallowing studies (VFSSs). Second, we explored the
effect of the chin-down maneuver in the presence or absence of vocal fold paralysis
(VFP) using FEES in patients with 3-field lymphadenectomy (3FL) postesophagectomy.
Design
Retrospective data collection from FEES and VFSS.
Setting
Dysphagic clinics in the ear, nose, and throat department.
Participants
Patients (N=15) underwent esophagectomy with 3FL at the Department of Gastroenterologic
Surgery, during a period of 12 months.
Interventions
The patients underwent FEES and VFSS with neutral and chin-down maneuvers 2 weeks
postoperatively. Two raters of speech pathology blindly scored aspiration, penetration,
delayed initiation, and pharyngeal clearance in the pyriform sinus and vallecula,
respectively, from recorded movie clips of both examinations, using the penetration
aspiration scale (PAS) and modified Hyodo FEES rating scale.
Main Outcome Measures
The intrarater and interrater correlation coefficients of each parameter examined
with FEES. Statistical comparison of each parameter between FEES and VFSS and of each
parameter evaluated using FEES between 2 maneuvers with or without VFP.
Results
The intrarater and interrater correlation coefficients of the PAS and pyriform sinus
examined with FEES were both statistically consistent between the 2 raters. The PAS
and pyriform sinus evaluated using FEES were significantly correlated with those evaluated
in a VFSS (P<.05). The 2 parameters evaluated using FEES were significantly (P<.05) improved with the chin-down maneuver compared to the neutral maneuver, especially
in VFP patients.
Conclusion
FEES performed postesophagectomy with 3FL for evaluation of aspiration is as reliable
statistically as VFSSs. The chin-down maneuver is especially useful for reducing the
PAS score and pyriform sinus in VFP patients.
Keywords
List of abbreviations:
3FL (3-field lymphadenectomy), FEES (fiberoptic endoscopic evaluation of swallowing), PAS (penetration aspiration scale), UES (upper esophageal sphincter), VFP (vocal fold paralysis), VFSS (videofluoroscopic swallowing study)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 01, 2018
Footnotes
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
