Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
Braz J Otorhinolaryngol. 2022 May-Jun;88(3):445-470. doi: 10.1016/j.bjorl.2021.03.002. Epub 2021 Apr 2.
Neurological alterations can generate swallowing disorders and fiberoptic endoscopic evaluation of swallowing is one of the tests performed for its diagnosis, as well as assistance in dysphagia management.
To identify and describe a fiberoptic endoscopic evaluation of swallowing standardized protocol for the neurological adult population and its stages.
Systematic review registered on the PROSPERO platform (CRD42018069428), carried out on the websites: MEDLINE, Cochrane Library and Scielo; published between 2009 and 2020. Randomized clinical trials, cross-sectional, and longitudinal studies were included. Two independent judges evaluated the study design and extracted the data from the selected studies. Doubts regarding inclusion or not of the studies were evaluated by a third judge. Scientific articles included were those with adult neurological remained patients with outcomes: (1) diagnosis of swallowing disorder (2) change in sensitivity in laryngeal region (3) penetration of food offered (4) aspiration of food offered.
3724 articles were initially selected, after personalized search for patients with neurological alterations 101 studies remained. In the end, 21 qualitative studies from 2009 to 2020 remained in the systematic review and they were described in detail and compared. Seven articles used protocols of the institutions in which the research took place and four mentioned using the same protocol. The reliable reproducibility of the protocols is feasible only in three of the articles, even presenting different protocols.
There is no standard or validated protocol to assess the swallowing function of adults with neurological diseases.
神经系统改变可导致吞咽障碍,纤维光学内镜吞咽评估是诊断吞咽障碍的一项检查,有助于吞咽障碍的管理。
确定并描述针对成人神经科患者的纤维光学内镜吞咽评估标准化方案及其各阶段。
在 PROSPERO 平台(CRD42018069428)上进行系统评价,检索 MEDLINE、Cochrane 图书馆和 Scielo 网站上 2009 年至 2020 年发表的文章。纳入随机临床试验、横断面研究和纵向研究。两名独立评审员评估研究设计并从入选研究中提取数据。对研究的纳入或排除存在疑问时,由第三名评审员进行评估。纳入的科学文章是针对存在吞咽障碍诊断(1)、喉区敏感性变化(2)、提供食物的穿透(3)、提供食物的吸入(4)等结局的成人神经科患者的研究。
最初筛选出 3724 篇文章,经个性化搜索神经改变患者后,仍有 101 篇研究。最终,系统评价中纳入了 2009 年至 2020 年的 21 项定性研究,并对其进行了详细描述和比较。其中 7 篇文章使用了所在研究机构的方案,4 篇文章提到使用相同的方案。仅有 3 篇文章中的方案具有可靠的可重复性,即使提出了不同的方案。
目前尚无评估成人神经科疾病患者吞咽功能的标准或经过验证的方案。