FEES as a second-stage tool in patients with dysphagia

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http://urn.fi/URN:NBN:fi:hulib-201705104078
Title: FEES as a second-stage tool in patients with dysphagia
Author: Björkman, Kajsa; Pietarinen, Petra; Mäkitie, Antti; Markkanen-Leppänen, Mari
Contributor: University of Helsinki, Faculty of Medicine
Publisher: Helsingfors universitet
Date: 2017
Language: eng
URI: http://urn.fi/URN:NBN:fi:hulib-201705104078
http://hdl.handle.net/10138/184226
Thesis level: master's thesis
Discipline: Otorhinolaryngology
Korva-, nenä- ja kurkkutaudit
Öron-, näs- och halssjukdomar
Abstract: Background: Fiberoptic endoscopic evaluation of swallowing (FEES) is an established non-invasive and radiation-safe evaluation method of the pharyngeal swallowing function. The focus is in the diagnosis of dysphagia, consideration of its treatment and in finding compensation techniques for impaired swallowing. We aimed at investigating the feasibility and outcome of FEES at our institution. Patients and Methods: The study group comprised all the 117 patients who had a FEES performed during the years 2011 and 2012 at the Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland. Results: Patients who were considered otherwise healthy prior to FEES presented significantly more often with globus symptoms compared with patients with a neurological disorder (p=0.009) or those diagnosed with a head and neck (HN) malignancy (p=0.011). Patients with a neurological disorder had significantly more aspiration (p=0.014), suffered more from swallowing initiation difficulties (p=0.031) and more often had a pneumonia (p<0.005) compared to the patients who had been considered healthy. Aspiration and pneumonia correlated with the underlying disease (r=0.382 p<0.005), as well as with the degree of dysphagia. Conclusions: FEES served well as a second-stage diagnostic tool for dysphagia in a multidisciplinary environment. Patients with no obvious underlying cause for dysphagia presented more often with globus, compared to patients with a diagnosed malignant tumour in the head and neck region, or with a neurological diagnosis. Aspiration, pneumonia and the degree of dysphagia correlated with the underlying cause of dysphagia.
Subject: FEES
endoscopy
head and neck cancer
dysphagia
globus
neurology


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