Pisegna Jessica M, Murray Joseph
Boston Medical Center, Boston, Massachusetts.
VA Ann Arbor Healthcare System, Ann Arbor, Michigan.
Semin Speech Lang. 2018 Feb;39(1):3-14. doi: 10.1055/s-0037-1608855. Epub 2018 Jan 22.
This article aims to review the use of laryngoscopy to assess swallowing function in the stroke population. Since its inception in 1988, fiberoptic endoscopic evaluation of swallowing (FEES) has become an established procedure with distinct objective findings and practical applications, enabling many to choose it as the primary instrumental tool in evaluating poststroke dysphagia. In this article, we outline the decision-making process of when to use FEES. We highlight considerations for the acute stroke patient and visual signs that guide decision making during a FEES, such as secretions, swallowing frequency, and pharyngeal squeeze elicitation. The application of the ice chip protocol for stroke patients who have been nil per os is discussed, along with common observable events on FEES performed on stroke patients like a delay, penetration/aspiration, and bolus retention. Finally, we briefly review testing interventions and follow-up readiness with FEES.
本文旨在综述喉镜检查在评估中风患者吞咽功能方面的应用。自1988年首次出现以来，纤维喉镜吞咽功能评估（FEES）已成为一种既定的检查方法，具有明确的客观发现和实际应用价值，使得许多人将其作为评估中风后吞咽困难的主要仪器工具。在本文中，我们概述了何时使用FEES的决策过程。我们强调了急性中风患者的注意事项以及FEES检查期间指导决策的视觉体征，如分泌物、吞咽频率和咽部挤压诱发情况。讨论了对禁食的中风患者应用冰屑试验方案，以及对中风患者进行FEES检查时常见的可观察到的情况，如延迟、渗透/误吸和食团潴留。最后，我们简要回顾了FEES的测试干预措施和随访准备情况。
