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      Simultaneous Radiological and Fiberendoscopic Evaluation of Swallowing (“SIRFES”) in Patients After Surgery of Oropharyngeal/Laryngeal Cancer and Postoperative Dysphagia

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          Abstract

          To compare the results of a simultaneously performed videofluoroscopic swallowing study and fiberendoscopic evaluation of swallowing in patients with dysphagia after surgery and radiotherapy for oropharyngeal or laryngeal cancer. This prospective study included 31 patients who were examined simultaneously with a standardized protocol. The fiberendoscopic and videofluoroscopic swallowing loops were independently scored by two otorhinolaryngologists/phoniatricians and two radiologists. The presence of penetration/aspiration, the amount of pharyngeal residues and the position of the bolus head when triggering of pharyngeal swallow begins were evaluated. Generalized linear models were used to model the impact of rater, method, bolus and quantities as well as specified moderation effects on scorings. In addition, post hoc Wilcoxon tests were used. Rater agreement was assessed using weighted kappas and their 95% confidence intervals. A total of 202 swallow sequences in 29 patients was evaluated. Interrater agreement was substantial to excellent for both methods (weighted k = 0.979–0.613). Significant differences between both methods were found when assessing the penetration-aspiration scale ( p = 0.001, tendency of higher scores by videofluoroscopic (median = 2.59) as opposed to fiberendoscopic (median = 2.14) and the residue severity scores in the valleculae ( p = 0.029) and the sinus piriformes ( p = 0.002) with larger residues scored by fiberendoscopic evaluation of swallowing. No significant differences were found regarding the time point of triggering ( p = 0.273). Simultaneous evaluation of swallowing with FEES and VFSS showed significantly different results in symptomatic patients after tumor operation and radiotherapy.

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          The online version of this article (10.1007/s00455-019-09979-8) contains supplementary material, which is available to authorized users.

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          MBS measurement tool for swallow impairment--MBSImp: establishing a standard.

          Bonnie Martin-Harris, Jay Brodsky, Sofía Castell … (2008)
          The aim of this study was to test reliability, content, construct, and external validity of a new modified barium swallowing study (MBSS) tool (MBSImp) that is used to quantify swallowing impairment. Multiple regression, confirmatory factor, and correlation analyses were used to analyze 300 in- and outpatients with heterogeneous medical and surgical diagnoses who were sequentially referred for MBS exams at a university medical center and private tertiary care community hospital. Main outcome measures were the MBSImp and index scores of aspiration, health status, and quality of life. Inter- and intrarater concordance were 80% or greater for blinded scoring of MBSSs. Regression analysis revealed contributions of eight of nine swallow types to impressions of overall swallowing impairment (p /= 0.5) that formed two impairment groupings (oral and pharyngeal). Significant correlations were found between Oral and Pharyngeal Impairment scores and Penetration-Aspiration Scale scores, and indexes of intake status, nutrition, health status, and quality of life. The MBSImp demonstrated clinical practicality, favorable inter- and intrarater reliability following standardized training, content, and external validity. This study reflects potential for establishment of a new standard for quantification and comparison of oropharyngeal swallowing impairment across patient diagnoses as measured on MBSS.
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            Assessing penetration and aspiration: how do videofluoroscopy and fiberoptic endoscopic evaluation of swallowing compare?

            A J Drinnan, Matthew S. Kelly, P Leslie-Steen (2007)
            We aimed to investigate whether the type of dysphagia examination (fiberoptic endoscopic evaluation of swallowing [FEES] or videofluoroscopy) influences the scoring of penetration and aspiration. Prospective, single-blind study. Fifteen dysphagic participants were recruited and underwent one FEES and one videofluoroscopy examination, performed and recorded simultaneously. Fifteen independent raters from 12 centers scored penetration and aspiration from recordings using the Penetration Aspiration Scale. Raters were blind to participant details, the pairing of the FEES and videofluoroscopy recordings, and the other raters' scores. Interrater and intrarater reliability were analyzed using weighted kappa. The Penetration Aspiration Scale scores were significantly higher for the FEES recordings than for the videofluoroscopy recordings (ANOVA P < .001). The mean difference between the FEES and videofluoroscopy penetration aspiration scores for the same swallows was 1.15 points. Interrater and intrarater reliability ranged from 0.64 to 0.79 (weighted kappa). Penetration aspiration is perceived to be greater (more severe) from FEES than videofluoroscopy images. The clinical implications are discussed.
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              Endoscopic and videofluoroscopic evaluations of swallowing and aspiration.

              Eric Olson, S Langmore, Erin Sauber-Schatz (1991)
              A new procedure for evaluating oropharyngeal dysphagia utilizing fiberoptic laryngoscopy was compared to the videofluoroscopy procedure. Twenty-one subjects were given both examinations within a 48-hour period. Results of the fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopy examinations were compared for presence or absence of abnormal events. Good agreement was found, especially for the finding of aspiration (90% agreement). The FEES was then measured against the videofluoroscopy study for sensitivity, specificity, positive predictive value, and negative predictive value. Sensitivity was 0.88 or greater for three of the four parameters measured. Specificity was lower overall, but was still 0.92 for detection of aspiration. It was concluded that the FEES is a valid and valuable tool for evaluating oropharyngeal dysphagia. Some specific patients and conditions that lend themselves to this procedure are discussed.
              Article 0 comments Cited 58 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                M. Scharitzer:
                ORCID: http://orcid.org/0000-0003-4427-5463
                0043-1-40400-48180 , martina.scharitzer@meduniwien.ac.at
                Bio :
                M. Scharitzer

                MD

                I. Roesner:
                Bio :
                I. Roesner

                MD

                P. Pokieser:
                Bio :
                P. Pokieser

                MD

                M. Weber:
                Bio :
                M. Weber

                Mag Dr

                D. M. Denk-Linnert:
                Bio :
                DM Denk-Linnert

                MD

                Journal
                Journal ID (nlm-ta): Dysphagia
                Journal ID (iso-abbrev): Dysphagia
                Title: Dysphagia
                Publisher: Springer US (New York )
                ISSN (Print): 0179-051X
                ISSN (Electronic): 1432-0460
                Publication date (Electronic): 14 February 2019
                Publication date PMC-release: 14 February 2019
                Publication date (Print): 2019
                Volume: 34
                Issue: 6
                Pages: 852-861
                Affiliations
                [1 ]GRID grid.22937.3d, ISNI 0000 0000 9259 8492, Department of Biomedical Imaging and Image-Guided Therapy, , Medical University of Vienna, ; Waehringer Guertel 18-20, 1090 Vienna, Austria
                [2 ]GRID grid.22937.3d, ISNI 0000 0000 9259 8492, Division of Phoniatrics-Logopedics, Department of Otorhinolaryngology, , Medical University of Vienna, ; Waehringer Guertel 18-20, 1090 Vienna, Austria
                [3 ]GRID grid.22937.3d, ISNI 0000 0000 9259 8492, Unified Patient Project, , Medical University of Vienna, ; Waehringer Guertel 18-20, 1090 Vienna, Austria
                Author information
                http://orcid.org/0000-0003-4427-5463
                Article
                Publisher ID: 9979
                DOI: 10.1007/s00455-019-09979-8
                PMC ID: 6825654
                PubMed ID: 30767078
                SO-VID: 2a580e96-4f52-4092-8902-3bc1151fd294
                Copyright © © The Author(s) 2019
                License:

                OpenAccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Date received : 11 June 2018
                Date accepted : 18 January 2019
                Categories
                Subject: Original Article
                Custom metadata
                issue-copyright-statement © Springer Science+Business Media, LLC, part of Springer Nature 2019

                ScienceOpen disciplines: Otolaryngology
                Keywords: cineradiography,endoscopy,deglutition,deglutition disorders,respiratory aspiration,pharyngeal neoplasms
                Data availability:
                ScienceOpen disciplines: Otolaryngology
                Keywords: cineradiography, endoscopy, deglutition, deglutition disorders, respiratory aspiration, pharyngeal neoplasms

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