Objective: To investigate the effect of fibreoptic endoscopic evaluation of swallowing (FEES) in the assessment of dysphagia.
Methods: Fifty-two patients with neurogenic dysphagia underwent FEES and videofluoroscopy (VF) within a 2-day period. The results obtained were compared.
Results: FEES with all consistencies revealed premature leakage in 48.1%, pooling in 75.0%, penetration in 69.2%, and aspiration in 55.8%, silent aspiration in 28.8% of patients. VF revealed above items in 44.2%, 63.5%, 57.7%, 46.2%, 21.2%, respectively. The FEES was then measured against the VF for sensitivity, specificity, positive predictive value, and negative predictive value. FEES showed higher sensibility and negative coincidence rate of penetration (90.0%, 81.3%), aspiration (87.5%, 87.0%) and silent aspiration (90.9%, 97.3%). According to the severity, the dysphagia in patients was classified into no penetration, penetration, aspiration and silent aspiration. A weighted Kappa value of 0.713 signified "substantial" agreement between the two tests.
Conclusions: FEES is an effective and valuable tool for evaluating oropharyngeal dysphagia, and is helpful in guiding the patients for diet and rehabilitation.