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Functional oesophagoscopy: endoscopic evaluation of the oesophageal phase of deglutition

Published online by Cambridge University Press:  20 January 2009

P C Belafsky*
Affiliation:
Center for Voice and Swallowing, Otolaryngology, University of California Davis School of Medicine, Sacramento, California, and the Center for Voice and Swallowing Disorders, Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
C J Rees
Affiliation:
Center for Voice and Swallowing, Otolaryngology, University of California Davis School of Medicine, Sacramento, California, and the Center for Voice and Swallowing Disorders, Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
*
Address for correspondence: Dr Peter C Belafsky, Center for Voice and Swallowing, University of California Davis School of Medicine, 2521 Stockton Blvd, Suite 7200, Sacramento, CA 95817, USA. Fax: +1 916 703 5011 E-mail: [email protected]

Abstract

Background:

The anatomy and function of the oropharynx and larynx during deglutition can be assessed using the flexible endoscope, but this evaluation does not provide information on the oesophagus. Guided observation of oesophageal swallowing enables extended dysphagia evaluation.

Objective:

To assess the diagnostic utility of guided observation of oesophageal swallowing in the evaluation of dysphagia.

Study design:

Retrospective case series.

Methods:

Procedures for guided observation of oesophageal swallowing were reviewed for oesophageal findings and compared with fluoroscopy and manometry.

Results:

Twenty-one patients underwent guided observation of oesophageal swallowing and concurrent videofluoroscopy and/or manometry. No complications of the former procedure occurred. The results of guided observation of oesophageal swallowing concurred with those of fluoroscopy in 15/21 cases (71 per cent) and with those of manometry in five of six (83 per cent) cases. Guided observation of oesophageal swallowing revealed anatomic pathology contributing to dysphagia in 15/21 (71 per cent) patients. The procedure identified pathology not detected by fluoroscopy and manometry in 13/21 (62 per cent) patients.

Conclusion:

Guided observation of oesophageal swallowing appears to be a safe diagnostic tool with which to evaluate the oesophageal phase of deglutition.

Type
Short Communications
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented at the 9th World Congress of the World Organization for Specialized Studies on Diseases of the Esophagus, April 6–9, 2008, Grimaldi Forum, Monaco.

References

1 Langmore, SE, Schatz, K, Olsen, N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 1988;2:216–19CrossRefGoogle ScholarPubMed
2 Aviv, JE, Murry, T, Zschommler, A, Cohen, M, Gartner, C. Flexible endoscopic evaluation of swallowing with sensory-testing: patient characteristics and analysis of safety in 1,340 consecutive examinations. Ann Otol Rhinol Laryngol 2005;114:173–6CrossRefGoogle Scholar
3 Cohen, MA, Setzen, M, Perlman, PW, Ditkoff, M, Mattucci, KF, Guss, J. The safety of flexible endoscopic evaluation of swallowing with sensory testing in an outpatient otolaryngology setting. Laryngoscope 2003;113:21–4CrossRefGoogle Scholar
4 Postma, GN, Cohen, JT, Belafsky, PC, Halum, SL, Gupta, SK, Bach, KK et al. Transnasal esophagoscopy: revisited (over 700 consecutive cases). Laryngoscope 2005;115:321–3CrossRefGoogle ScholarPubMed
5 Amin, MR, Postma, GN, Setzen, M, Koufman, JA. Transnasal esophagoscopy: a position statement from the American Bronchoesophagological Association (ABEA). Otolaryngol Head Neck Surg 2008;138:411–14CrossRefGoogle ScholarPubMed
6 Fuller, L, Huprich, JE, Theisen, J, Hagen, JA, Crookes, PF, Demeester, SR et al. Abnormal esophageal body function: radiographic-manometric correlation. Am Surg 1999;65:911–14CrossRefGoogle ScholarPubMed
7 Shakespear, JS, Blom, D, Huprich, JE. Correlation of radiographic and manometric findings in patients with ineffective esophageal motility. Surg Endosc 2004;18:459–62Google ScholarPubMed
8 Livingstone, RS, Augustine, P, Aparna, I, Raj, DV. Dose audit and evaluation of work practices during barium procedures using digital radiography. Health Phys 2004;87:358–65CrossRefGoogle ScholarPubMed
9 Tutuian, R, Castell, DO. Combined multichannel intraluminal impedance and manometry clarifies esophageal function abnormalities: study in 350 patients. Am J Gastroenterol 2004;99:1011–19CrossRefGoogle ScholarPubMed
10 Prasad, GA, Talley, NJ, Romero, Y, Arora, AS, Kryzer, LA, Smyrck, TC et al. Prevalence and predictive factors of eosinophilic esophagitis in patients presenting with dysphagia: a prospective study. Am J Gastroenterol 2007;102:2627–32CrossRefGoogle ScholarPubMed
11 Attila, T, Hellman, RS, Krasnow, AZ, Hofmann, CL, Saeian, K, Dua, KS et al. Feasibility and safety of endoscopic evaluation of gastric emptying. Endoscopy 2005;37:240–3CrossRefGoogle ScholarPubMed