Oropharyngeal Dysphagia Assessment in Behçet Disease Using EAT-10 and Fiberoptic Endoscopic Evaluation of Swallowing

To provide a preliminary symptom-based and standardized single-consistency FEES screening assessment of swallowing in adults with Behçet disease using the Eating Assessment Tool-10 (EAT-10) and fiberoptic endoscopic evaluation of swallowing (FEES).

This single-center cross-sectional observational study with prospective enrollment was conducted between September 2022 and March 2024. Adult patients with Behçet disease completed the EAT-10 and underwent FEES using an IDDSI level 3 moderately thick bolus (yellow pudding). FEES outcomes were scored using the Penetration-Aspiration Scale (PAS), Yale Pharyngeal Residue Severity Rating Scale for vallecular and pyriform sinus residue (YPRSRS-V and YPRSRS-P), Functional Outcome Swallowing Scale (FOSS), and Functional Oral Intake Scale (FOIS).

Twenty-seven patients were included (20 women, 7 men). Mean age was 45.7 ± 8.0 years and mean disease duration was 10.4 ± 7.6 years. The mean EAT-10 score was 4.0 ± 6.6, and 10 patients (37.0%) had an abnormal EAT-10 score (≥ 3). With the tested IDDSI level 3 bolus, PAS was ≥ 2 in 1 patient (3.7%). Vallecular residue (YPRSRS-V ≥ 2) was observed in 5 patients (18.5%) and pyriform sinus residue (YPRSRS-p ≥ 2) in 2 patients (7.4%). FOSS was ≥ 2 in 1 patient (3.7%), and FOIS was ≤ 6 in 1 patient (3.7%).

In Behçet disease, patient-reported swallowing complaints were relatively common, whereas objective FEES evidence of penetration or aspiration was uncommon. Pharyngeal residue, particularly vallecular residue, was more frequent than airway invasion under this standardized bolus condition. EAT-10-based screening with selective FEES may help identify patients who may benefit from multidisciplinary swallowing evaluation.

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