International consensus (ICON) on assessment of oropharyngeal dysphagia

• Published in: European annals of otorhinolaryngology, head and neck diseases Vol. 135; no. 1; pp. S17 - S21
• Main Authors: Espitalier, F., Fanous, A., Aviv, J., Bassiouny, S., Desuter, G., Nerurkar, N., Postma, G., Crevier-Buchman, L.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: France Elsevier Masson SAS 01.02.2018
• Subjects: Deglutition Disorders - diagnosis; Deglutition self-evaluation questionnaire; Endoscopic evaluation of swallowing; Humans; Internationality; Oropharyngeal dysphagia; Practice Guidelines as Topic; Swallowing score; Videofluoroscopic swallowing study; Swallowing score; Videofluoroscopic swallowing study; Oropharyngeal dysphagia; Endoscopic evaluation of swallowing; Deglutition self-evaluation questionnaire
• ISSN: 1879-7296; 1879-730X
• DOI: 10.1016/j.anorl.2017.12.009

To present international recommendations regarding the proper evaluation of oropharyngeal dysphagia (OD), both objectively and subjectively (self-evaluation). Following a thorough review of the literature, 5 experts in the field from 4 different continents answered separately a questionnaire regarding the work-up of OD. Individual answers were presented and discussed during the world ENT conference that was held in Paris in June 2017. This article will present the recommendations issued from that meeting. For the initial objective assessment of OD, it is recommended to perform either a functional endoscopic evaluation of swallowing (FEES) or a videofluoroscopic swallowing study (VFSS). FEES is the more popular investigation given its increased ease of use and accessibility. When evaluating for the presence of aspiration during the objective evaluation of OD, it is recommended to perform either a FEES or a VFSS. In this case, FEES is the favored investigation given its likely increased sensitivity. In order to highlight the presence of oropharyngeal food residue following the deglutition process, it is recommended to perform either a FEES or a VFSS; FEES likely being the more sensitive investigation while VFSS allows a better quantification of the amount of pharyngeal residue. Is it also recommended to objectify the quality of the deglutition process by means of a score during the objective evaluation of OD. Finally, it is recommended to utilize a self-evaluation questionnaire during research studies exploring the deglutition process.