Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.
Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, U.S.A.
Laryngoscope. 2021 May;131(5):1088-1094. doi: 10.1002/lary.29194. Epub 2020 Oct 26.
OBJECTIVES/HYPOTHESIS: Dysphagia encompasses a complex compilation of symptoms which often differ from findings of objective swallowing evaluations. The purpose of this investigation was to compare the results of subjective dysphagia measures to objective measures of swallowing in patients evaluated in a multidisciplinary dysphagia clinic.
Prospective cohort study.
The study cohort included all patients evaluated in the multidisciplinary dysphagia clinic over 24 months. Participants were evaluated by a multidisciplinary team including a laryngologist, gastroenterologist, and speech-language pathologist. Evaluation included a videofluoroscopic swallowing study (VFSS), fiberoptic endoscopic evaluation of swallowing (FEES), and transnasal esophagoscopy (TNE). Data collected included diet (FOIS), Eating Assessment Tool (EAT-10) score, Reflux symptom index (RSI) score, and the findings of the VFSS exam.
A total of 75 patients were included in the analysis. The average EAT-10 score was 16.3 ± 2.1, RSI was 21.4 ± 0.6, and FOIS score was 6.0 ± 1.33. VFSS revealed impairments in the oral phase in 40% of the cohort, pharyngeal in 59%, and esophageal in 49%. Abnormalities were noted in one phase for 32%, in 2 phases in 32%, and three phases in 18%. Patients with abnormal pharyngeal findings on VFSS had significantly higher EAT-10 scores (P = .04). Patients with abnormal oral findings on VFSS were noted to have significantly lower FOIS scores (P = .03).
Data presented here demonstrate a relationship between patient reported symptoms and objective VFSS findings in a cohort of patients referred for multidisciplinary swallowing assessment suggesting such surveys are helpful screening tools but inadequate to fully characterize swallowing impairment.
3 Laryngoscope, 131:1088-1094, 2021.
目的/假设：吞咽困难包含一系列复杂的症状，这些症状往往与客观吞咽评估的结果不同。本研究的目的是比较主观吞咽障碍评估与多学科吞咽障碍诊所患者的客观吞咽评估结果。
前瞻性队列研究。
研究队列包括在多学科吞咽障碍诊所进行评估的所有患者，研究时间为 24 个月。参与者由包括喉科医生、胃肠病学家和言语病理学家在内的多学科团队进行评估。评估包括视频荧光透视吞咽研究（VFSS）、纤维内镜吞咽评估（FEES）和经鼻食管镜检查（TNE）。收集的数据包括饮食（FOIS）、吞咽评估工具（EAT-10）评分、反流症状指数（RSI）评分和 VFSS 检查结果。
共有 75 例患者纳入分析。EAT-10 评分平均为 16.3±2.1，RSI 为 21.4±0.6，FOIS 评分为 6.0±1.33。VFSS 显示 40%的患者口腔期有损伤，59%的患者咽部有损伤，49%的患者食管有损伤。32%的患者在一个阶段有异常，32%的患者在两个阶段有异常，18%的患者在三个阶段有异常。VFSS 发现咽部异常的患者 EAT-10 评分显著升高（P=.04）。VFSS 发现口腔异常的患者 FOIS 评分显著降低（P=.03）。
本研究结果表明，多学科吞咽评估患者中，患者报告的症状与客观 VFSS 结果之间存在一定的相关性，这表明此类调查是有用的筛查工具，但不足以全面描述吞咽障碍。
3 级喉镜，131：1088-1094，2021 年。
