title: Comparison between videofluoroscopy, fiberoptic endoscopy and scintigraphy for diagnosis of oro-pharyngeal dysphagia.
abstract: The purpose of this study was to compare videofluoroscopy (VFS), fiberoptic endoscopic evaluation of swallowing (FEES) and oro-pharyngo- oesophageal scintigraphy (OPES) with regards to premature spillage, post-swallowing residue and aspiration to assess the reliability of these tests for detection of oro-pharyngeal dysphagia. Sixty patients affected with dysphagia of various origin were enrolled in the study and submitted to VFS, FEES and OPES using a liquid and semi-solid bolus. As a reference, we used VFS. Both the FEES and the OPES showed good sensitivity with high overall values (≥ 80% and ≥ 90% respectively). The comparison between FEES vs VFS concerning drop before swallowing showed good specificity (84.4% for semi-solids and 86.7% for liquids). In the case of post-swallowing residue, FEES vs VFS revealed good overall validity (75% for semi-solids) with specificity and sensitivity well balanced for the semi-solids. OPES vs. VFS demonstrated good sensitivity (88.6%) and overall validity (76.7%) for liquids. The analysis of FEES vs. VFS for aspiration showed that the overall validity was low (≤ 65%). On the other hand, OPES demonstrated appreciable overall validity (71.7%). VFS, FEES and OPES are capable of detecting oro-pharyngeal dysphagia. FEES gave significant results in the evaluation of post-swallowing residues.
authors.affiliation: ENT, Audiology and Phoniatric Unit, Department of Neurosciences, University of Pisa, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Fattori
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Pisa, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Giusti
authors.affiliation: ENT, Audiology and Phoniatric Unit, Department of Neurosciences, University of Pisa, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Mancini
authors.affiliation: Regional Centre of Nuclear Medicine, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Grosso
authors.affiliation: Audiology and Phoniatric Unit, University of Napoli 2, Italy.
authors.forename: M R
authors.initials: MR
authors.lastname: Barillari
authors.affiliation: Institute of Clinical Physiology of the Italian National Research Council (IFC-CNR), Pisa, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Bastiani
authors.affiliation: Institute of Clinical Physiology of the Italian National Research Council (IFC-CNR), Pisa, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Molinaro
authors.affiliation: ENT, Audiology and Phoniatric Unit, Department of Neurosciences, University of Pisa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Nacci
mesh_terms: D003679:Deglutition; D003680:Deglutition Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004724:Endoscopy; D005260:Female; D005336:Fiber Optic Technology; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D014741:Video Recording
keywords: Dysphagia; Fiberoptic Endoscopic Evaluation of Swallowing; Oro-pharyngo-oesophageal Scintigraphy; Speech-language pathology; Videofluoroscopy