Métodos Diagnósticos En Disfagia Alta

PROGRAM DESCRIPTION: Changes found in the complex mechanism of swallowing, whether as a primary consequence of diseases, which include strokes, neurodegenerative diseases, head and neck cancer and traumatic brain injuries, or as a secondary effect of surgical, radiotherapy and/or chemotherapy treatment, characterize dysphagia. Clinical history, anamnesis and validated questionnaires on swallowing assessment are important to select patients who should be investigated instrumentally. Videoendoscopy and videofluoroscopy of swallowing are instrumental assessment methods for detecting laryngeal penetration and aspiration. Aspiration may result in malnutrition, dehydration, pneumonia, airway obstruction and reduced quality of life, being a factor in morbidity and mortality among dysphagic patients. Videoendoscopic evaluation allows the assessment of glottic motor function, pharyngeal stasis, pre/post-swallowing aspiration and the effects of therapeutic maneuvers at the bedside and in the office, in a more accessible way and without exposure to radiation. However, there is limitation in the evaluation of the pharyngeal phase, due to the loss of direct vision between the transition from the oral phase to the pharyngeal phase, caused by the blackout effect of the anteroposterior movement of the base of the tongue, making it difficult to evaluate laryngeal penetrations and tracheal aspirations during swallowing. Videofluoroscopy enables complete assessment of all phases of swallowing and presents great sensitivity and specificity in detecting the presence of aspiration. However, there is difficulty in patient access, exposure to radiation, and it must be carried out in a hospital setting. There is controversy about the role and indication of instrumental swallowing assessment methods.
Moderador: Dr. Rogério Dedivitis
- Dados clínicos, de exámen físico y cuestionarios, Dr. Carlos Chone
- Videoendoscopía de la deglución, Dra. María Viti
- Videofluoroscopía de la deglución, Dra. Lara Fernandez
- Algoritmo diagnóstico: como eligir? Dr. Rogério Dedivitis

OUTCOME OBJECTIVE 1: To select patients who are candidates to instrumental evaluation of swallowing.

OUTCOME OBJECTIVE 2: To recognize the indication, limitation and main findings of videoendoscopy and videofluoroscopy of swallowing.

OUTCOME OBJECTIVE 3: To discuss the possible causes and indicate an appropriate algorhythm for evaluating patients dysphagia.

BACKGROUND STATEMENT: Clinical history, anamnesis and validated questionnaires on swallowing are important to select patients who should be investigated instrumentally. There is controversy about the role and indication of videoendoscopy and videofluoroscopy of swallowinginstrumental swallowing.

Comprehensive Otolaryngology Track Statement :