Department of Rehabilitation Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Department of Otorhinolaryngology, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Yonsei Med J. 2019 Dec;60(12):1181-1186. doi: 10.3349/ymj.2019.60.12.1181.
To examine correlations among rating scales and findings suggestive of tracheal aspiration and pharyngeal residue between fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallowing study (VFSS) in dysphagia patients.
We studied patients referred to our hospital for dysphagia assessment. Three raters judged the residue severity and laryngeal penetration or tracheal aspiration of FEES and VFSS. The raters applied the Penetration-Aspiration Scale (PAS) for tracheal aspiration and pixel-based circumscribed area ratio and Yale Pharyngeal Residue Severity for post-swallow residue in VFSS and FEES, respectively. Anatomy-physiologic findings during FEES associated with tracheal aspiration were also analyzed.
A total of 178 participants were enrolled in our study. In correlation analysis, PAS (=0.74), vallecula retention (=0.76), and pyriform sinus retention (=0.78) showed strong positive correlations between FEES and VFSS. Intra-rater agreement between VFSS and FEES was good for PAS (κ=0.65) and vallecula (κ=0.65) and pyriform sinus retention (κ=0.69). Among 72 patients who showed subglottic shelf residue, a suspected finding of aspiration, in FEES, 68 had concomitant tracheal aspiration during VFSS. Both vocal fold hypomobility and glottic gap during phonation were significantly associated with findings suggestive of tracheal aspiration during FEES (<0.05).
Quantitative and reliable aspiration and post swallow residue rating scales showed strong positive correlations and good agreement between VFSS and FEES.
研究纤维内镜吞咽检查（FEES）与视频透视吞咽检查（VFSS）中提示气管吸入和咽部残留的评分与发现之间的相关性，以评估吞咽障碍患者的情况。
我们研究了因吞咽问题而被转诊到我院的患者。三位评估者分别对 FEES 和 VFSS 的咽部残留严重程度和喉穿透或气管吸入进行评估。评估者使用气管吸入的渗透-吸入量表（PAS）和基于像素的限定区域比以及耶鲁咽部残留严重程度，分别对 VFSS 和 FEES 的吞咽后残留进行评分。还分析了 FEES 期间与气管吸入相关的解剖生理发现。
共有 178 名参与者参与了我们的研究。在相关性分析中，PAS（=0.74）、 vallecula 滞留（=0.76）和 pyriform 窦滞留（=0.78）在 FEES 和 VFSS 之间显示出强烈的正相关。PAS（κ=0.65）和 vallecula（κ=0.65）以及 pyriform 窦滞留（κ=0.69）在 VFSS 和 FEES 之间的评估者间一致性良好。在 72 名 FEES 中出现杓状软骨架残留（疑似吸入的可疑发现）的患者中，68 名患者在 VFSS 中同时出现气管吸入。声带运动不足和发声时声门间隙均与 FEES 中提示气管吸入的发现显著相关（<0.05）。
定量且可靠的吸入和吞咽后残留评分在 VFSS 和 FEES 之间显示出强烈的正相关和良好的一致性。
