title: The value of oropharyngoesophageal scintigraphy in the management of aspiration into the tracheobronchial tree in neurological patients.
abstract: OBJECTIVE
  Dysphagia and bolus aspiration are two of the most frequent and invalidating symptoms of various neurological diseases. Swallowing disorders often lead to tracheobronchial aspiration with consequent pneumonia episodes. Aspiration pneumonia per se constitutes the most frequent cause of death in these patients, with mortality rate ranging from 20% to 62%. Oropharyngoesophageal scintigraphy (OPES) permits functional quantitative assessment of the different stages of swallowing, together with the detection and quantitative measurement of bolus aspiration. In this work, we analyzed the role of OPES in patients with different neurological conditions to evaluate swallowing and to detect and quantify bolus aspiration.
  
  
  METHODS
  We enrolled 43 neurological patients (25 women and 18 men, mean age 67.3±12.4 yr) complaining of dysphagia with suspected inhalation. All patients underwent OPES with (99m)Tc-nanocolloid using a liquid bolus first, followed by a semi-solid bolus. We evaluated the following parameters: Oral, Pharyngeal and Esophageal Transit Time, Oro-Pharyngeal Retention Index, Esophageal Emptying Rate, and Aspiration Rate (% AR).
  
  
  RESULTS
  OPES detected some airway aspiration in 26/43 patients. 19 patients had tracheal aspiration (with a mean 18.1% AR) and the remaining 7 patients had bilateral broncho-pulmonary aspiration (mean 44.9% AR).
  
  
  CONCLUSIONS
  OPES is a feasible, repeatable and noninvasive method that allows quantitative assessment of bolus aspiration into the tracheobronchial tract, thus representing a useful and accurate tool to guide the most appropriate treatment and to monitor response to therapy in neurological patients with dysphagia.
authors.affiliation: Regional Centre of Nuclear Medicine, Santa Chiara Hospital, University Hospital of Pisa, Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Grosso
authors.affiliation: Ear, Nose and Throat Audiology Phoniatrics Unit, University Hospital of Pisa, Pisa, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Fattori
authors.affiliation: Regional Centre of Nuclear Medicine, Santa Chiara Hospital, University Hospital of Pisa, Pisa, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Volterrani
authors.affiliation: Department of Nuclear Medicine, Santa Maria della Misericordia Hospital, Rovigo, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Chondrogiannis
authors.affiliation: Regional Centre of Nuclear Medicine, Santa Chiara Hospital, University Hospital of Pisa, Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Boni
authors.affiliation: Ear, Nose and Throat Audiology Phoniatrics Unit, University Hospital of Pisa, Pisa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Nacci
authors.affiliation: Department of Nuclear Medicine, Santa Maria della Misericordia Hospital, Rovigo, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Marzola
authors.affiliation: Department of Nuclear Medicine, Santa Maria della Misericordia Hospital, Rovigo, Italy. Electronic address: domenico.rubello@libero.it.
authors.forename: D
authors.initials: D
authors.lastname: Rubello
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi / Q000000981:diagnostic imaging*; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications*; D011015:Pneumonia, Aspiration / Q000000981:diagnostic imaging* / Q000209:etiology; D011877:Radionuclide Imaging / Q000379:methods; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D014132:Trachea / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid
keywords: Aspiration pneumonia; Disfagia; Dysphagia; Gammagrafía orofaringeoesofágica; Neumonía por aspiración; Oropharyngoesophageal scintigraphy; Tracheo-bronchial aspiration; Traqueobroncoaspiración