Aviv Jonathan E, Murry Thomas, Zschommler Anne, Cohen Manderly, Gartner Carolyn
Voice and Swallowing Center, Department of Otolaryngology-Head and Neck Surgery, College of Physicians and Surgeons, Columbia University, Columbia University Medical Center, New York-Presbyterian Hospital, New York, New York 10032, USA.
Ann Otol Rhinol Laryngol. 2005 Mar;114(3):173-6. doi: 10.1177/000348940511400301.
Flexible endoscopic evaluation of swallowing with sensory testing (FEESST) is a comprehensive endoscopic assessment of the sensory and motor components of a swallow. Previous studies addressing patient safety issues with respect to FEESST included relatively small numbers of patients and paid almost no attention to patient characteristics. The purpose of this study was to determine the incidence of FEESST-related complications in the outpatient and inpatient settings and to analyze patient diagnoses that led to the performance of FEESST. We performed a prospective study of FEESST complications in 1,340 consecutive evaluations performed over a 4 1/2-year period. The primary outcome variables were incidence of epistaxis and airway compromise. The secondary outcome variable was underlying patient diagnoses. The incidence of epistaxis was 1 in 1,340 (0.07%). There were no instances of airway compromise. Stroke was the most common reason for the performance of FEESST (343; 25.6%), followed by cardiac-related dysphagia (298; 22.2%) following open heart surgery (169/298; 56.7%), heart attack, congestive heart failure, or new arrhythmia. The remaining causes were head and neck cancer (207; 15.4%), pulmonary disease (141; 10.5%), chronic neurologic disease (124; 9.3%), and acid reflux disease (80; 6.0%). We conclude that FEESST is a relatively safe procedure for the sensory and motor assessment of dysphagia in a cohort of patients with a wide variety of underlying diagnoses. The emergence of cardiac surgery as a common cause of dysphagia warrants further study.
吞咽功能的柔性内镜评估及感觉测试（FEESST）是对吞咽的感觉和运动成分进行的全面内镜评估。以往针对FEESST患者安全问题的研究纳入的患者数量相对较少，且几乎未关注患者特征。本研究的目的是确定门诊和住院环境中FEESST相关并发症的发生率，并分析导致进行FEESST的患者诊断情况。我们对在4年半时间内连续进行的1340次FEESST评估进行了前瞻性研究。主要结局变量是鼻出血和气道受损的发生率。次要结局变量是患者的基础诊断。鼻出血的发生率为1/1340（0.07%）。未发生气道受损情况。中风是进行FEESST最常见的原因（343例；25.6%），其次是心脏直视手术后与心脏相关的吞咽困难（298例；22.2%）（169/298；56.7%）、心脏病发作、充血性心力衰竭或新发心律失常。其余原因包括头颈癌（207例；15.4%）、肺部疾病（141例；10.5%）、慢性神经疾病（124例；9.3%）和胃酸反流疾病（80例；6.0%）。我们得出结论，对于一大群有各种基础诊断的患者，FEESST是一种相对安全的吞咽困难感觉和运动评估方法。心脏手术作为吞咽困难的常见原因这一情况值得进一步研究。
