Classification of sequential swallowing types using videoendoscopy with high reproducibility and reliability.

Area of Science:

• Otolaryngology
• Swallowing Physiology
• Medical Imaging

Background:

• Videofluoroscopy (VF) is standard for swallowing assessment but involves radiation.
• Sequential swallowing types require precise classification for accurate diagnosis.
• Alternative methods with high reliability are needed.

Purpose of the Study:

• To classify sequential swallowing types using radiation-free videoendoscopy (VE).
• To compare VE classification with videofluoroscopy (VF) findings.
• To evaluate the reproducibility and reliability of VE for swallowing analysis.

Main Methods:

• Twenty-one healthy adults underwent simultaneous VF and VE during sequential straw drinking.
• Swallows were classified into segmental or continuous types based on laryngeal vestibule (VF) and velopharynx (VE) dynamics.
• Test-retest, interrater, and intrarater reliability were assessed.

Main Results:

• VE classified 95 V-segmental and 33 V-continuous swallows, closely mirroring VF's L-segmental and L-continuous classifications.
• Laryngeal vestibule closure on VF corresponded to velopharyngeal closure on VE in 127/128 swallows (κ = 0.98).
• High test-retest reproducibility and interrater/intrarater reliability were observed for VE.

Conclusions:

• Videoendoscopy (VE) demonstrates high reproducibility and reliability for classifying sequential swallowing types.
• VE offers a viable, radiation-free alternative to VF for detailed swallowing analysis.
• The findings support VE's utility in clinical swallowing assessments.