Farneti D
Audiology and Phoniatrician Unit, lnfermi Hospital, Rimini, Italy.
Acta Otorhinolaryngol Ital. 2008 Jun;28(3):135-40.
The finding of secretions and bolus pooling is of great diagnostic interest in the evaluation of subjects with swallowing disorders. Bedside evaluation alone, in subjects at risk for aspiration, can underestimate this parameter. The usefulness of endoscopic investigation for the evaluation of subjects with swallowing disorders is stressed, in order to plan treatment and follow-up. Based on endoscopic evaluation of material pooling we devised a score expressing the severity of dysphagia. This value takes into account endoscopic landmarks and other parameters of bedside evaluation. Endoscopic and bedside data were collected from a heterogeneous population of 520 consecutive patients seen in our Service over a 6-year period. By means of the test of equality of group means and logistic regression, parameters able to significantly predict aspiration in the series were identified. An ordinal number was attributed to each parameter in order to obtain scores expressing three degrees of severity of dysphagia: mild, moderate, severe. The scores can be used to guide the management of patients in a simple way, providing indications for targeted referral to the speech pathologist and for tracking the disorder over time. This investigation represents the basis for future research aimed at validating the scores in a larger case series.
在评估吞咽障碍患者时，发现分泌物和食团积聚具有重要的诊断意义。对于有误吸风险的患者，仅进行床边评估可能会低估这一参数。强调了内镜检查在评估吞咽障碍患者中的作用，以便规划治疗和随访。基于对物质积聚的内镜评估，我们设计了一个表示吞咽困难严重程度的评分。该评分考虑了内镜标志和床边评估的其他参数。在6年期间，我们从本科室连续诊治的520例不同患者群体中收集了内镜和床边数据。通过组均值相等性检验和逻辑回归，确定了该系列中能够显著预测误吸的参数。为每个参数赋予一个序数，以获得表示吞咽困难三个严重程度等级的评分：轻度、中度、重度。这些评分可用于以简单的方式指导患者的管理，为有针对性地转诊至言语病理学家以及随时间跟踪病情提供依据。本研究是未来旨在在更大病例系列中验证这些评分的研究基础。
