[Evaluation of pharyngeal swallowing elicited by fluid infusion using videoendoscopy in dysphagia patients]

The purpose of this study was to investigate the clinical value of assessing pharyngeal swallowing elicited by fluid infusion. Videoendoscopic examinations were performed in 126 patients with dysphagia, after injecting a fluid infusion into the pharyngeal cavity. Blue dye fluid was instilled into the unilateral vallecula through a catheter that was inserted into the biopsy channel of an endoscope. Pharyngeal swallowing elicited by the fluid infusion was classified according to 5 grades: grade 1, normal pharyngeal swallowing; grade IIa, laryngeal penetration before the triggering of pharyngeal swallowing; grade IIb, pharyngeal residue after swallowing; grade IIa + b; and grade III, no the pharyngeal swallowing. The recovery rates for oral intake using several approaches for dysphagia were 98% in grade I patients and 75% in grade IIb patients. However, the oral intake of food was more difficult in grade IIa, grade IIa + b and grade III patients. These results suggest that the classification of dysphagia based on the triggering and output situation of pharyngeal swallowing may be a useful guideline for demonstrating impaired oral food intake. We conclude that videoendoscopic examination using a fluid infusion is a valuable method for evaluating pharyngeal swallowing minus the influence of bolus transport from oral cavity to the pharynx.