[The role of oropharyngoesophageal scintigraphy in the assessment of dysphagia in neurological patients.]

Abstract

PURPOSE:

The aim of this study was to assess the role of oropharingoesophageal scintigraphy (OPES) in the management of neurological patients, investigating the clinical value of semiquantitative analysis.

MATERIALS AND METHODS:

We enrolled 39 neurological patients clinically evaluated and scored according to the Dysphagia Outcome Severity Scale (DOSS) scale who underwent fibrolaryngoscopic swallowing examination (FEES) and OPES using a 99mTc-nanocolloid-radioblabelled semiliquid bolus. We calculated the following semiquantitative parameters: Oral Transit Time (OTT), Pharyngeal Transit Time (PTT), Esophageal Transit Time (ETT), Retention Index (RI), and Esophageal Emptying Rate (EER10s). Differences in OPES semiquantitative parameters between patients classified according to the DOSS scale were performed using the nonparametric Mann-Whitney U test. Optimal semiquantitative parameters cut-off values that correlated with DOSS classification were investigated with ROC curves. The agreement between OPES, FEES and DOSS results was measured using Cohen's Kappa test (K).

RESULTS:

A significantly higher OTT (p=0.028), PTT (p=0.011) and ETT (p=0.030) and lower EER10s (p=0.016) values were identified. Moderate agreement resulted between OPES and DOSS results (k=0.429, 95%CI: 0.143-0.715, p=0.002).

CONCLUSIONS:

Our study revealed a significant correlation between clinical dysphagia graded using DOSS scale and semiquantitative parameters obtained by OPES evaluation. Despite reliable and reproducible OPES results, allowing an adequate study also of the esophageal phase, nowadays scintigraphic study remains an underestimated method to be considered in the diagnosis of dysphagia and related complications.

• Authors: Anna Giulia Nappi, Corinna Altini, Claudia D'Alò, Marisa Megna, Artor Niccoli Asabella, Maria Luisa Fiorella, Dino Rubini, Angela Sardaro, Antonio Rosario Pisani
• Journal: Recenti progressi in medicina (Recenti Prog Med) Vol. 113 Issue 12 Pg. 739-748 (12 2022) ISSN: 2038-1840 [Electronic] Italy
• Vernacular Title: Ruolo dello studio scintigrafico del transito orofaringoesofageo nella valutazione della disfagia nei pazienti affetti da patologia neurologica.
• PMID: 36420850 (Publication Type: English Abstract, Journal Article)

Topics

• Humans
• Deglutition Disorders (diagnostic imaging, etiology)
• Deglutition
• Radionuclide Imaging
• Statistics, Nonparametric