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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