Abstract:
Flexible endoscopic evaluation of swallowing (FEES) is one of the most important methods for instrumental swallowing evaluation. The most challenging part of the examination consists in the interpretation of the various observations encountered during endoscopy and in the deduction of clinical consequences. This review proposes the framework for an integrated FEES-report that systematically moves from salient findings of FEES to more advanced domains such as dysphagia severity, phenotypes of swallowing impairment and pathomechanisms. Validated scales and scores are used to enhance the diagnostic yield. In the concluding part of the report, FEES-findings are put into the perspective of the clinical context. The potential etiology of dysphagia and conceivable differential diagnoses are considered, further diagnostic steps are proposed, treatment options are evaluated, and a timeframe for re-assessment is suggested. This framework is designed to be adaptable and open to continuous evolution. Additional items, such as novel FEES protocols, pathophysiological observations, advancements in disease-related knowledge, and new treatment options, can be easily incorporated. Moreover, there is potential for customizing this approach to report on FEES in structural dysphagia.
摘要:
灵活的内窥镜吞咽评估(FEES)是仪器吞咽评估的最重要方法之一。检查中最具挑战性的部分在于对内窥镜检查过程中遇到的各种观察结果的解释以及对临床后果的推断。这篇综述提出了综合FEES报告的框架,该报告系统地从FEES的显着发现转移到更高级的领域,例如吞咽困难的严重程度。吞咽障碍和病理机制的表型。使用验证的量表和评分来提高诊断率。在报告的结论部分,FEES的发现被纳入临床背景的角度。考虑了吞咽困难的潜在病因和可能的鉴别诊断,提出了进一步的诊断步骤,评估治疗方案,并提出了重新评估的时间表。该框架被设计为适应性强,可持续发展。附加项目,例如新的费用协议,病理生理观察,疾病相关知识的进步,和新的治疗选择,可以很容易地结合。此外,有可能定制这种方法来报告结构性吞咽困难的费用。