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Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging
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Simultaneous modified Evans blue dye procedure and video nasal endoscopic evaluation of the swallow

J Donzelli1, S Brady, M Wesling

  • 1Otolaryngology Head and Neck Surgery, Limited, Carol Stream, Illinois, USA.

The Laryngoscope
|January 22, 2002
PubMed
Abstract

Insights

The modified Evans blue dye test (MEBD) has a 50% false-negative rate for detecting aspiration in patients with tracheostomies. It is only a screening tool for gross aspiration, missing trace amounts.

Area of Science:

  • Otolaryngology
  • Speech-Language Pathology
  • Gastroenterology

Background:

  • Dysphagia is common in patients with tracheostomies.
  • Accurate aspiration detection is crucial for patient management.
  • The modified Evans blue dye test (MEBD) is a common screening tool.

Purpose of the Study:

  • To compare the aspiration detection rate of the MEBD with video nasal endoscopic examination of the swallow (VEES).
  • To evaluate the accuracy of MEBD in patients with tracheostomies.

Main Methods:

  • Prospective study of 15 simultaneous MEBD and VEES procedures.
  • Patients with tracheostomies and suspected dysphagia were included.
  • Direct subglottic visualization was performed via endoscopy.

Main Results:

  • Aspiration was detected in 53% of studies by VEES.
  • MEBD had a 50% false-negative rate compared to VEES.
  • MEBD missed all trace aspirations (0%) but detected gross aspiration in 67%.

Conclusions:

  • MEBD is unreliable for detecting all aspiration in tracheostomized patients.
  • MEBD should only be used as a screening tool for gross aspiration.
  • VEES is a more sensitive method for aspiration detection in this population.

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