ROLE OF VIDEOENDOSCOPY IN ASSESSMENT OF PHARYNGEAL FUNCTION IN OROPHARYNGEAL DYSPHAGIA - COMPARISON WITH VIDEOFLUOROSCOPY AND MANOMETRY

Objective: The purpose of the current report is to evaluate the abilit y of videoendoscopic swallowing study in assessing pharyngeal propulsi on and aspiration episodes when compared with videofluoroscopy and man ometry. Study Design: Prospective study. Methods: Thirty-four patients with oropharyngeal dysphagia underwent videoendoscopy of swallowing t o assess pharyngeal propulsion as pathologic or non-pathologic, and as piration. These features were compared with those found on manometry a nd videofluoroscopy, which were considered as the reference examinatio ns. Sensitivity, specificity, and positive and negative predictive val ues of videoendoscopy were estimated, with their 95% confidence interv als. Results: A total agreement between videoscopy and videofluoroscop y was found in 76.4% of cases for pharyngeal propulsion and in 82.3% f or aspiration. This rate for pharyngeal propulsion and in 82.3% for as piration. This rate for pharyngeal propulsion reached 82.3% between vi deoendoscopy and manometry. Moreover, in 24 cases (70.5) in which vide ofluoroscopy and manometry agreed for pharyngeal propulsion, 22 were a ssessed similarly through fiberoscopy. When using fluoroscopy and mano metry as reference examinations, videoendoscopy detected nearly 90% (9 5% confidence interval [CI] = 0.80, 1.0) of impaired pharyngeal propul sion. Concerning aspiration, 70% (95% CI = 0.54, 0.85) of events detec ted by videoendoscoopy were also observed on videofluoroscopy. Sensiti vity, specificity, and positive and negative predictive values of vide oendoscopy reached a higher rate (90% to 92.8%) when agreement was fou nd between fluoroscopy and manometry. Conclusions: Videoendoscopy is a n examination that can be used to detect inexpensively phgaryngeal pro pulsion disorder and aspiration episodes.