Lapa Sriramya
Klinik für Neurologie, Zentrum für Neurologie und Neurochirurgie, Universitätsklinikum Frankfurt Goethe Universität, Schleusenweg 2-16, 60590, Frankfurt am Main, Deutschland.
Nervenarzt. 2023 Aug;94(8):664-675. doi: 10.1007/s00115-023-01517-0. Epub 2023 Jun 28.
Neurogenic dysphagia is a frequent symptom in a variety of neurological diseases. The establishment of the flexible endoscopic evaluation of swallowing (FEES) in the field of neurology has led to improvements in the diagnostics and treatment of patients with dysphagia.
The aim of this review is to present the development of the FEES examination in the field of neurology. Furthermore, the additive value in the diagnostic classification of neurogenic dysphagia is elucidated and the impact on treatment management in patients with dysphagia is highlighted.
Narrative literature review.
The FEES examination is a safe and well-tolerated method for the diagnostics of neurogenic dysphagia. It enables the valid investigation of the swallowing function within the very heterogeneous neurological patient population. It has become an important diagnostic tool, not only in the assessment of the severity of dysphagia and the risk of aspiration but also as a reliable method for the etiological classification of symptoms of deglutition disorders. As FEES can be performed at the bedside and does not require radiation exposure, it can be used not only to examine critically ill patients (point of care diagnostics) but also to monitor treatment.
The systematic endoscopic evaluation of swallowing is established as an important functional diagnostic tool in the field of neurology. Further developments to increase the use of FEES in clinically related disciplines such as neurosurgery, neuro-oncology or psychiatry are pending.
神经源性吞咽困难是多种神经系统疾病中的常见症状。神经领域中吞咽功能的软性内镜评估(FEES)的建立,已使吞咽困难患者的诊断和治疗得到改善。
本综述的目的是介绍神经领域中FEES检查的发展。此外,阐明其在神经源性吞咽困难诊断分类中的附加价值,并强调其对吞咽困难患者治疗管理的影响。
叙述性文献综述。
FEES检查是诊断神经源性吞咽困难的一种安全且耐受性良好的方法。它能够在非常多样化的神经科患者群体中对吞咽功能进行有效检查。它已成为一种重要的诊断工具,不仅用于评估吞咽困难的严重程度和误吸风险,而且作为一种可靠的方法用于对吞咽障碍症状进行病因分类。由于FEES可以在床边进行且无需暴露于辐射,它不仅可用于检查重症患者(床旁诊断),还可用于监测治疗。
吞咽的系统性内镜评估已成为神经领域重要的功能诊断工具。在神经外科、神经肿瘤学或精神病学等临床相关学科中增加FEES使用的进一步发展尚待进行。