Fiberoptic endoscopic evaluation of swallowing in swallowing disorders – fees-. Case report at Popayán, Colombia.

  • Rodrigo Molina-García Clínica La Estancia, Popayán-Colombia
  • Diego Velasco-Cárdenas Universidad del Cauca Departamento de Ciencias quirúrgicas
  • Lucía Arroyo-Castillo Clínica La Estancia, Popyán-colombia
  • Diana valencia-Solano Fisiocenter, Popayán-Colombia
  • Andrés Vargas Universidad del Cauca
Keywords: Dysphagia, stroke, Fiberoptic Endoscopic Evaluation, aspirative pneumonia

Abstract

Dysphagia is a frequently pathological condition in pa­tients with stroke and carries a substantial risk of dehy­dration, malnutrition and aspiration pneumonia. So far there are two methods for diagnosis; Videofluoroscopy (VFC) and Fiberoptic Endoscopic Evaluation of Swa­llowing (FEES). The first is considered the gold standard method, with a high cost, radiation exposure that requires the transfer of the patient to radiology, the patient’s abili­ty to follow simple commands and time required to com­plete. VFC does not replicate physiological conditions in which the patient is routinely, so it is considered that its representation is limited, the second test is an alternative procedure to be more economical, safe, well tolerated, wi­dely available, lasting approximately 20 minutes and with the possibility of doing it in the patient’s bed. Unlike FVC, to evaluate the presence of pharyngeal, this correlates with the risk of aspiration. Clinical report: The objective of this report is to present a male patient, 33 years old, who admitted to a health institution because it presents a clini­ cal picture compatible with stroke, as findings found right hemiplegia and swallowing disorder, as required gastros­tomy tubes. We performed Fiberoptic Endoscopic Evalua­tion of Swallowing (FEES) as a diagnostic method, which allowed visualization of the anatomic and functional en­vironment, the type of food consistency could be secure in their feeding process, thus avoiding silent aspirations and insights that could lead an aspiration pneumonia. It also allowed the group to make recommendations for nutritio­nal support, physiotherapy and speech therapy for ambu­latory management of the patient.

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References

Nazar G, Ortega A, Fuentealba I. Evaluación y Manejo Integral de la Disfagia Orofaríngea. Rev. Med. Clin. Condes. 2009; 20(4) 449 – 457

Donzelli J, Brady S, Wesling M, Craney M. Predictive value of accumulated oropharyngeal secretions for aspiration during video nasal endoscopic evaluation of the swallow. Ann Otol Rhinol Laryngol 2003; 112: 469-475

Smith CA, Goldstein LB, Horner RD, Ying J, Gray L, Gonzalez-Rothi L, Bolser DC. Predicting Aspiration in Patients With Ischemic Stroke. Chest. 2009; 135(3):769-77

Lind CD. Dysphagia: evaluation and treatment. Gastroenterol Clin N Am 2003; 32: 553-57

Wisdom G, Blitzer A. Surgical therapy for swallowing disorders. Otolaryngol Clin North Am. 1998; 31:537-60

Giorge JH. Evaluación y tratamiento de la deglución con nasofibrolaringoscopia en pacientes con disfagia y aspiración. AN ORL MEX. 2007; 52(4):147-149

Dziewas R, Ritter M, Schilling M, et al. Pneumonia in acute stroke patients fed by nasogastric tube. J Neurol Neurosurg Psychiatry. 2004; 75(6):852-856

Wilkins T, Gillies RA, Thomas AM, Wagner PJ. The prevalence of dysphagia in primary care patients: a HamesNet Research Network study. J Am Board Fam Med. 2007; 20(2):144-50

Martino R, Foley N, Bhogal S, et al. Dysphagia after stroke: incidence, diagnosis and pulmonary complications. Stroke. 2005; 36:2756–63

Lin LC, Wu SC, Chen HS, et al. Prevalence of impaired swallowing in institionalized older people in Taiwan. J Am Geriatr Soc. 2002; 50:1118–23

Giorge JH. Evaluación y tratamiento de la deglución con nasofibrolaringoscopia en pacientes con disfagia y aspiración. AN ORL MEX. 2007; 52(4):147-149

Martino R, Foley N, Bhogal S, et al. Dysphagia after stroke: incidence, diagnosis and pulmonary complications. Stroke. 2005; 36:2756–63

Bastian RW. Videoendoscopic evaluation of patients with dysphagia: an adjunct to the modified barium swallows. Otolaryngol Head Neck Surg. 1991; 104:339-50

Kaye GM, Zorowitz RD, Baredes S. Role of flexible laryngoscopy in evaluating aspiration. Ann Otol Rhinol Laryngol. 1997; 106:705-9

Langmore SE, Mur AH, Cassella SB.The irritable Larynx. Otolaryngol Head Neck Surg. 2004; 131:137-8

Hiss SG, Postma GN. Fiberoptic endoscopic evaluation of swallowing. Laryngoscope. 2003; 113:1386-93

Clavé P, Terré R, de Kraa M, Serra M. Approaching oropharyngeal dysphagia. Rev Esp Enferm Dig.2004;96:2;119-131

Langmore SE, Schatz K, Olsen N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 1988; 2 (4): 216-9

Wu CH, Hsiao TY, Chen JC, Chang YC, Lee SY. Evaluation of swallowing safety with fiberoptic endoscope: comparison with videofluoroscopic technique. Laryngoscope 1997; 107:396-401

Langmore SE, Schatz K, Olson N. Endoscopic and videofluoroscopic evaluation of swallowing and aspiration. Ann Otol Rhinol Laryngol. 1991; 100(8):678-81

Warnecke T, Teismann I, Oelenberg S, Hamacher C, Bernd E. The Safety of Fiberoptic Endoscopic Evaluation of Swallowing in Acute Stroke. 2009,40:482-486

Finucane TE, Bynum JPW. Use of tubefeeding to prevent aspiration pneumonia. Lancet 1996; 348:1421-4. 26

Nazar G, Ortega A, Godoy A, Godoy JM, Fuentealba I. 1.Evaluación fibroscópica de la deglución. Rev. Otorrinolaringol. Cir. Cabeza Cuello 2008; 68:131-142 27

How to Cite
(1)
Molina-García, R.; Velasco-Cárdenas, D.; Arroyo-Castillo, L.; valencia-Solano, D.; Vargas, A. Fiberoptic Endoscopic Evaluation of Swallowing in Swallowing Disorders – Fees-. Case Report at Popayán, Colombia. Rev. Fac. Cienc. Salud Univ. Cauca 2011, 13, 23-27.
Published
2011-09-01
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