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ORIGINAL RESEARCH

Fiberoptic Endoscopic Evaluation and Management of Dysphage in Our Clinic of Patients with Difficulty Swallowing Due to Cerebrovascular Occlusion
Serebrovasküler Okluzyon Nedeniyle Yutma Güçlüğü Yaşayan Hastaların Kliniğimizde Fiberoptik Endoskopik Olarak Değerlendirilmesi ve Disfaji Yönetimi
Received Date : 17 Oct 2022
Accepted Date : 25 Oct 2023
Available Online : 29 Nov 2023
Doi: 10.24179/kbbbbc.2022-93902 - Makale Dili: EN
Journal of Ear Nose Throat and Head Neck Surgery. 2024;32(1):1-7
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Various methods have been developed today for dysphagia monitoring. Fiberoptic Endoscopic (FE) evaluation is one of these methods. In our study, we aimed to evaluate patients with swallowing difficulties due to CVO with FE examination and to convey the treatment methods applied. Material and Methods: Between January 2017 and December 2021, medical records, patient demographics, neurological diagnosis, FE results of 72 patients with dysphagia due to CVO and FE were evaluated and penetration aspiration scores (PAS), functional oral intake scale (FOAS), NIH (National Institutes of health) swallowing safety scale scores were calculated. 10 patients who came for follow-up were re-evaluated with FE and compared according to PAS, FOAS and NIH swallowing safety values. Results: The patients' FE findings were categorized and according to PAS scoring, the average value was calculated as 3.58+2.44, the FOAS average value was 5.06+1.97, and the NIH swallowing safety average value was calculated as 1.42+1.6. According to the comparison results of 10 patients who could be re-evaluated with endoscopic examination after treatment during follow-up, a significant improvement was detected in PAS, NIH swallowing safety and FOAS values (p<0.05). Conclusion: Thanks to the objective evaluation with FE, the diagnosis of dysphagia can be made earlier and it can provide visible information in terms of treatment and follow-up. Therefore, evaluation of every patient with suspected dysphagia with FE will allow us to minimize possible complications and reduce the risk of mortality due to dysphagia.
ÖZET
Amaç: Disfaji takibi açısından günümüzde çeşitli yöntemler geliştirilmiştir. Fiberoptik Endoskopik (FE) değerlendirme bu yöntemlerden birisidir. Bizde çalışmamızda SVO nedeniyle yutma güçlüğü yaşayan hastaların FE muayene ile değerlendirilmesi ve uygulanan tedavi yöntemlerini aktarmayı amaçladık. Gereç ve Yöntemler: Ocak 2017 ile Aralık 2021 yılları arasında SVO nedeniyle disfaji problemi olan ve FE uygulanan 72 hastanın tıbbi kayıtları, hasta demografisi, nörolojik tanı, FE sonuçları değerlendirildi ve penetrasyon aspirasyon skorları (PAS), fonksiyonel oral alım skalası (FOAS), NIH(National Institues of health) yutma güvenlik skalası skorları hesaplandı ve hastalar arasında karşılaştırma yapıldı. Bulgular: Hastaların FE bulguları kategorize edilip PAS skorlamasına göre ortalama değer 3,58+2,44, FOAS ortalama değeri 5.06+1.97 NIH yutma güvenliği ortalama değeri 1.42+1.6 olarak hesaplandı. Takiplerde tedavi sonrası endoskopik muayene ile yeniden değerlendirilme yapılabilen 10 hastanın karşılaştırma sonucuna göre PAS, NIH yutma güvenliği ve FOAS değerlerinde anlamlı bir düzelme saptandı (p<0.05). Sonuç: FE ile yapılan objektif değerlendirme sayesinde disfaji tanısı daha erken dönemde konulabilmekte ve tedavi ile takip açısından gözle görülebilir bilgiler sunabilmektedir. Bundan dolayı disfaji şüphesi olan her hastanın FE ile değerlendirilmesi olası komplikasyonları en aza indirmemize olanak sağlayacak ve disfajiye bağlı mortalite riskini azaltacaktır.
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