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Correlations between Aspiration and Pharyngeal Residue Scale Scores for Fiberoptic Endoscopic Evaluation and Videofluoroscopy

Yonsei Medical Journal 2019년 60권 12호 p.1181 ~ 1186
윤진아 ( Yoon Jin-A ) - Pusan National University School of Medicine Pusan National University Hospital Department of Rehabilitation Medicine

 ( Kim Sang-Hun ) - Pusan National University School of Medicine Pusan National University Hospital Department of Rehabilitation Medicine
 ( Jang Myung-Hun ) - Pusan National University School of Medicine Pusan National University Hospital Department of Rehabilitation Medicine
김성동 ( Kim Sung-Dong ) - Pusan National University School of Medicine Pusan National University Hospital Department of Otorhinolaryngology
신용범 ( Shin Yong-Beom ) - Pusan National University School of Medicine Pusan National University Hospital Department of Rehabilitation Medicine

Abstract


Purpose: To examine correlations among rating scales and findings suggestive of tracheal aspiration and pharyngeal residue between fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallowing study (VFSS) in dysphagia patients.

Materials and Methods: We studied patients referred to our hospital for dysphagia assessment. Three raters judged the residue severity and laryngeal penetration or tracheal aspiration of FEES and VFSS. The raters applied the Penetration-Aspiration Scale (PAS) for tracheal aspiration and pixel-based circumscribed area ratio and Yale Pharyngeal Residue Severity for post-swallow residue in VFSS and FEES, respectively. Anatomy-physiologic findings during FEES associated with tracheal aspiration were also analyzed.

Results: A total of 178 participants were enrolled in our study. In correlation analysis, PAS (r=0.74), vallecula retention (r=0.76), and pyriform sinus retention (r=0.78) showed strong positive correlations between FEES and VFSS. Intra-rater agreement between VFSS and FEES was good for PAS (κ=0.65) and vallecula (κ=0.65) and pyriform sinus retention (κ=0.69). Among 72 patients who showed subglottic shelf residue, a suspected finding of aspiration, in FEES, 68 had concomitant tracheal aspiration during VFSS. Both vocal fold hypomobility and glottic gap during phonation were significantly associated with findings suggestive of tracheal aspiration during FEES (p<0.05).

Conclusion: Quantitative and reliable aspiration and post swallow residue rating scales showed strong positive correlations and good agreement between VFSS and FEES.

키워드

Deglutition; deglutition disorders; vocal cord dysfunction; endoscopes; fluoroscopy
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