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Comparison of functional endoscopic swallow study (FESS) vs. videofluoroscopy (VF) in patients with stroke

Patients with dysphagia present great morbidity and mortality, especially those with neurological disorders and/or head and neck surgery, thus warranting a detailed evaluation of swallowing. Videofluoroscopy has been considered the gold standard for evaluating swallowing disorders for many years; however, this test presents limitations in some clinical settings exposing patients to radiation and to the risk of contrast aspiration. In recent years, functional swallow studies using flexible endoscopy (FESS) have been proposed as a quick and highly sensitive way to evaluate patients with dysphagia. AIM: Comparative analysis between NFL and VD in relation to some parameters studied by both of them. STUDY DESIGN: Control study. MATERIAL AND METHODS: Twelve patients with sequelae of ischemic brain strokes were studied prospectively from January to May, 2002. All patients were submitted to VF and FESS with final statistical analysis of the results. RESULTS: VF is essential to evaluate the oral phase and micro aspirations, as well as the triggering of the swallow reflex in the pharyngeal phase. FESS may not visualize the triggering of the pharyngeal phase but is capable of testing the motility and sensibility of the larynx and it also allows direct vision of the food in the pharynx and/or larynx. No statistically significant difference was found for any of the parameters studied when comparing FESS and VF (McNemar test). CONCLUSION: The comparative analysis between the results of NFL and VD in patients with disphagia showed no significant differences between them.

dysphagia; functional endoscopic swallow study; videofluoroscopy


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