Development of a New Scale for Pharyngeal Residue Using Videofluoroscopic Swallowing Study and Fiberoptic Endoscopy
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Objective: To develop a new scale considering pharyngeal residue measurement by videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES) together and compared this new scale to a previous one. Method: A total of 69 participants (65.2±12.1 years) with dysphagia were included. All subjects were examined by VFSS and FEES simultaneously. The test foods were a 5-ml rice porridge, curd type yogurt and 2-ml thin fluid. The vallecular and pyriform sinus residue were measured using pharyngeal residue severity scale (PRSS) which has 5 steps by VFSS and FEES. We set the detailed criteria of PRSS using the height of vallecular and pyriform sinus residue on the lateral image of VFSS and the upper-most cross-sectional area of these residues on FEES image. Considering the three-dimensional structure of pharyngeal space, we obtained new scale by multiplying scales in both measurements. Then the PRSS of each test (VFSS, FEES) and new scale were analyzed to check the correlation with swallowing function. Result: The new scale obtained by multiplying scales of both VFSS and FEES ranged from 1 to 25 scores, with 14 steps. In the correlation with swallowing function, a new scale demonstrated a similar correlation with the Clinical Dysphagia Scale and the American Speech-Language-Hearing Association National Outcome Measurement System. Conclusion: This new scale is a simple method which reflects both the three-dimensional structure of pharyngeal residues and the clinical severity of dysphagia well. (JKDS 2013;3:70-77)
Abstract
Objective: To develop a new scale considering pharyngeal residue measurement by videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES) together and compared this new scale to a previous one. Method: A total of 69 participants (65.2±12.1 years) with dysphagia were included. All subjects were examined by VFSS and FEES simultaneously. The test foods were a 5-ml rice porridge, curd type yogurt and 2-ml thin fluid. The vallecular and pyriform sinus residue were measured using pharyngeal residue severity scale (PRSS) which has 5 steps by VFSS and FEES. We set the detailed criteria of PRSS using the height of vallecular and pyriform sinus residue on the lateral image of VFSS and the upper-most cross-sectional area of these residues on FEES image. Considering the three-dimensional structure of pharyngeal space, we obtained new scale by multiplying scales in both measurements. Then the PRSS of each test (VFSS, FEES) and new scale were analyzed to check the correlation with swallowing function. Result: The new scale obtained by multiplying scales of both VFSS and FEES ranged from 1 to 25 scores, with 14 steps. In the correlation with swallowing function, a new scale demonstrated a similar correlation with the Clinical Dysphagia Scale and the American Speech-Language-Hearing Association National Outcome Measurement System. Conclusion: This new scale is a simple method which reflects both the three-dimensional structure of pharyngeal residues and the clinical severity of dysphagia well. (JKDS 2013;3:70-77)
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