Table 1 Differential indication of instrumental dysphagia diagnostics for the evaluation of neurogenic dysphagia [65]
From: Diagnosis and treatment of neurogenic dysphagia – S1 guideline of the German Society of Neurology
Methods of instrumental dysphagia evaluation | Indications |
|---|---|
Endoscopy (FEES) | gold standard; particularly suitable for assessment of saliva accumulation and for sensory testing, preferred method in stroke units and neurological intensive care units |
Videofluoroscopy (VFSS) | gold standard; evaluation of all swallowing phases; particularly suitable for assessing intra-deglutitive aspiration, hyolaryngeal elevation, epiglottic tilt, contact of the tongue-base to the back of the pharyngeal wall and impaired opening of the upper oesophageal sphincter |
Manometry | Recording of timing and amplitude of the pharyngeal and oesophageal contraction and impaired opening of upper and lower oesophageal sphincter (in particular important before possible cricopharyngeal myotomy), oesophageal motility disorders |
Electromyography (EMG) | biofeedback, otherwise mainly experimental procedure |
Sonography | currently mainly experimental procedure |
Magnetic resonance imaging (MRI) | currently mainly experimental procedure |
Computer tomography (CT) | currently mainly experimental procedure |