Transnasal Endoscopic Evaluation of Swallowing: A Bedside Technique to Evaluate Ability to Swallow Pureed Diets in Elderly Patients with Dysphagia

Sakamoto, Torao; Horiuchi, Akira; Nakayama, Yoshiko

doi:10.1155/2013/646373

Cited by 13 publications

(8 citation statements)

References 14 publications

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“…4,22,23 CT, X-ray, and MRI imaging are carried out to establish the diagnosis, and to assess the esophagus, the barium swallow test and esophageal and laryngeal endoscopy with the option of taking a biopsy are conducted. 4,27,44,51,52 An intrinsic cause (e.g. esophageal stricture, motility disorder, diverticula, neoplasms, etc.)…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of anterior cervical osteophytes causing dysphagia

Ruetten

Baraliakos

Godolias

et al. 2019

J Orthop Surg (Hong Kong)

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Dysphagia due to anterior cervical osteophytes is a rare condition. However, it can become serious enough to permanently impair the quality of life up to making normal food intake impossible. If conservative treatment fails, there is the option of surgical resection of the osteophytes. The objective of this study was to assess the outcomes of resections of anterior cervical osteophytes causing spondylogenic dysphagia, taking literature into consideration. Method: Resection of anterior cervical osteophytes using a standard anterior approach was performed in 14 consecutive patients with spondylogenic dysphagia between 2009 and 2015. Indomethacin or radiation was used to prevent recurrence. Imaging and clinical data were collected in follow-up examinations over an average of 50 months. Results: The osteophytes were sufficiently resected in all cases. Anterior plates were placed in three patients due to pronounced segmental mobility. Five patients were given recurrence prevention in the form of indomethacin, nine with radiation. One patient required revision surgery for a hematoma. No other serious complications were observed. All patients had significant improvement of their symptoms. No recurrences or signs of increasing instability were found during the follow-up period. Conclusion: When conservative treatment fails, surgical resection of cervical osteophytes is a sufficient method for treating spondylogenic dysphagia. High patient satisfaction and improvement of the quality of life are achieved with a low complication rate. Routine additional stabilization has been discussed as recurrence prevention. Prophylaxis using indomethacin or radiation, known primarily from hip replacement, also appears to be an option.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of anterior cervical osteophytes causing dysphagia

Ruetten

Baraliakos

Godolias

et al. 2019

J Orthop Surg (Hong Kong)

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“…The endoscope was moved between swallowing and the post swallow position to collect the data as described previously. [ 9 , 10 ] Images of the oropharynx and larynx were displayed on a monitor and recorded on the digital video recorder (Olympus, HVO-3300MT).…”

Section: Methodsmentioning

confidence: 99%

Pureed diets containing a gelling agent to reduce the risk of aspiration in elderly patients with moderate to severe dysphagia

et al. 2020

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“…Oropharyngeal dysphagia has been identified as a serious risk factor for patients developing aspiration pneumonia [13,14]. Endoscopy allows for direct observation of food accumulation in the pyriform sinus and other risks such as food entering below the vocal cords, which is common with oropharyngeal dysphagia [15][16][17]. With upper gastrointestinal (UGI) endoscopy, clinicians can observe the amount and location of accumulated pooling secretions in the pharyngolaryngeal region [17][18][19][20].…”

Section: Of 10mentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy versus Nasogastric Tube Feeding: Oropharyngeal Dysphagia Increases Risk for Pneumonia Requiring Hospital Admission

et al. 2019

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Background: Aspiration pneumonia is the most common cause of death in patients with percutaneous endoscopic gastrostomy (PEG) and nasogastric tube (NGT) feeding. This study aimed to compare PEG versus NGT feeding regarding the risk of pneumonia, according to the severity of pooling secretions in the pharyngolaryngeal region. Methods: Patients were stratified by endoscopic observation of the pooling secretions in the pharyngolaryngeal region: control group (<25% pooling secretions filling the pyriform sinus), pharyngeal group (25–100% pooling secretions filling the pyriform sinus), and laryngeal group (pooling secretions entering the laryngeal vestibule). Demographic data, swallowing level scale score, and pneumonia requiring hospital admission were recorded. Results: Patients with NGT (n = 97) had a significantly higher incidence of pneumonia (episodes/person-years) than those patients with PEG (n = 130) in the pharyngeal group (3.6 ± 1.0 vs. 2.3 ± 2.1, P < 0.001) and the laryngeal group (3.8 ± 0.5 vs. 2.3 ± 2.2 vs, P < 0.001). The risk of pneumonia was significantly higher in patients with NGT than in patients with PEG (adjusted hazard ratio = 2.85, 95% CI: 1.46–4.98, P < 0.001). Cumulative proportion of pneumonia was significantly higher in patients with NGT than with PEG for patients when combining the two groups (pharyngeal + laryngeal groups) (P = 0.035). Conclusion: PEG is a better choice than NGT feeding due to the decrease in risk of pneumonia requiring hospital admission, particularly in patients with abnormal amounts of pooling secretions accumulation in the pyriform sinus or leak into the laryngeal vestibule.

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Transnasal Endoscopic Evaluation of Swallowing: A Bedside Technique to Evaluate Ability to Swallow Pureed Diets in Elderly Patients with Dysphagia

Abstract: Pharyngeal residues and saliva pooling predicted impaired swallowing of pureed foods. Transnasal EES performed by a gastroenterologist provided a unique bedside method of assessing the ability to swallow pureed foods in elderly patients with dysphagia.

Cited by 13 publications

References 14 publications

Surgical treatment of anterior cervical osteophytes causing dysphagia

Surgical treatment of anterior cervical osteophytes causing dysphagia

Pureed diets containing a gelling agent to reduce the risk of aspiration in elderly patients with moderate to severe dysphagia

Percutaneous Endoscopic Gastrostomy versus Nasogastric Tube Feeding: Oropharyngeal Dysphagia Increases Risk for Pneumonia Requiring Hospital Admission

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