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Endoskopie heute 2015; 28(02): 125-131
DOI: 10.1055/s-0035-1553730
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Endoskopische Dysphagiediagnostik

Endoscopic Evaluation of Dysphagia
K. Hörmann
1   Universitäts-HNO-Klinik Mannheim
,
R. Dziewas
2   Klinik für Allgemeine Neurologie, Universitätsklinikum Münster
,
S. Graf
3   Hals-Nasen-Ohrenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
,
H. Feußner
4   Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
,
V. Becker
5   II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
› Author Affiliations
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Publication History

Publication Date:
07 December 2015 (online)

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Zusammenfassung

Dysphagie ist ein weit gefasster Sammelbegriff für Schluckstörungen. Die differenzialdiagnostische Eingrenzung kann im klinischen Alltag bereits durch eine ausgiebige Anamnese und fachspezifische Untersuchung gelingen. Dennoch bedarf es zur diagnostischen Sicherung und Ausschluss von Differenzialdiagnosen weiterer apparativer Diagnostik. Mittlerweile steht uns eine Vielzahl von diagnostischen Möglichkeiten zur Verfügung. In dieser Übersicht soll die endoskopische Diagnostik detailliert dargestellt werden. Trotz moderner Bildgebung ist jedoch eine ausreichende klinische Expertise und möglichst ein interdisziplinäres Gremium zur gemeinsamen Diskussion und Therapiefestlegung im täglichen Alltag entscheidend.

Abstract

Dysphagia is a broad collective term for swallowing disorders. In daily clinical practice further differential diagnostic determination is possible by means of a comprehensive anamnesis and specialist examination. Nevertheless further apparatus-based diagnosis is required for confirmation as well as to exclude differential diagnoses. In the meantime a multitude of diagnostic possibilities are available. This overview is intended to provide a detailed description of endoscopic diagnostics. However despite modern imaging the decisive factors in everyday practice are sufficient clinical expertise and wherever possible interdisciplinary case conferences to discuss and decide on treatment.

Schlüsselwörter

Endoskopie - Dysphagie - Diagnostik

Key words

endoscopy - dysphagia - diagnostics
 

  • Literatur

  • 1 Koop H et al. S2k-Leitlinie: Gastroösophageale Refluxkrankkheit. Z Gastroenterol 2014; 52: 1299-1346
    PubMedSearch in Google Scholar
  • 2 Eisen GM, Baron TH, Dominitz JA et al. Complications of upper GI endoscopy. Gastrointestinal Endosc 2002; 55: 784-793
    CrossrefPubMedSearch in Google Scholar
  • 3 von Arnim U, Miehlke S, Madisch A et al. Eosinophilic esophagitis – update – pathogenesis, diagnosis and therapy. Z Gastroenterol 2014; 52 (03) 296-305 Epub 2014 Mar 12.
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Edmonson JM. History of the instruments for gastrointestinal endoscopy. Gastrointest Endosc 1991; 37 (02) 27-56
    CrossrefPubMedSearch in Google Scholar
  • 5 Sharma SJ, Linke JJ, Kroll T et al. Praxis der Tumorendoskopie an deutschen HNO-Kliniken. Laryngo-Rhino-Otol 2013; 92 (03) 166-169
    PubMedSearch in Google Scholar
  • 6 Glaws WR, Erzkorn KP, Wenig BL. Comparison of rigid and flexible esophagoscopy in the diagnosis of esophageal disease: diagnostic accuracy, complications, and cost. Ann Otol Rhinol Laryngol 1996; 105: 262-266
    CrossrefPubMedSearch in Google Scholar
  • 7 Schmidt H, Hörmann K, Stasche N. HNO-Leitlinie Tracheo-Bronchoskopie. Laryngo-Rhino-Otol 2010; 89: 473-476
    PubMedSearch in Google Scholar
  • 8 Schmidt H, Hörmann K, Stasche N. HNO-Leitlinie Ösophagoskopie. Laryngo-Rhino-Otol 2010; 89: 540-543 (EFirst)
    PubMedSearch in Google Scholar
  • 9 Langmore SE. Scoring a FEES examination. In: Langmore SE, Hrsg. Endoscopic Evaluation and Treatment of Swallowing Disorders. New York: Thieme; 2001: 101-143
    Search in Google Scholar
  • 10 Langmore SE, Schatz K, Olsen N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 1988; 2 (04) 216-219
    Search in Google Scholar
  • 11 Schröter-Morasch H. Klinische Untersuchung des Oropharynx und videoendoskopische Untersuchung der Schluckfunktion. In: Bartolome G, Schröter-Morasch H, Editors Schluckstörungen – Diagnostik und Rehabilitation. München, Jena: Urban & Fischer; 2010: 173-208
    Search in Google Scholar
  • 12 Langmore SE. Endoscopic evaluation and treatment of swallowing disorders. New York, Stuttgart: Thieme; 2001
    Search in Google Scholar
  • 13 Warnecke T, Dziewas R. Neurogene Dysphagien – Diagnostik und Therapie. Stuttgart: Kohlhammer Verlag; 2013
    Search in Google Scholar
  • 14 Kelly AM, Drinnan MJ, Leslie P. Assessing penetration and aspiration: how do videofluoroscopy and fiberoptic endoscopic evaluation of swallowing compare?. Laryngoscope 2007; 117: 1723-1727
    CrossrefPubMedSearch in Google Scholar
  • 15 Kelly AM, Leslie P, Beale T et al. Fibreoptic endoscopic evaluation of swallowing and videofluoroscopy: does examination type influence perception of pharyngeal residue severity?. Clin Otolaryngol 2006; 31: 425-432
    Search in Google Scholar
  • 16 Wu CH, Hsiao TY, Chang YC et al. Evaluation of swallowing safety with fiberoptic endoscope: comparison with videofluoroscopic technique. Laryngoscope 1997; 107: 396-401
    Search in Google Scholar
  • 17 Leder SB. Serial fiberoptic endoscopic swallowing evaluations in the management of patients with dysphagia. Arch Phys Med Rehabil 1998; 79: 1264-1269
    CrossrefPubMedSearch in Google Scholar
  • 18 Langmore SE. Evaluation of oropharyngeal dysphagia: which diagnostic tool is superior?. Curr Opin Otolaryngol Head Neck Surg 2003; 11: 485-489
    Search in Google Scholar
  • 19 Murray J. Endoscopic mechanics and technique. In: Langmore SE, Editor Endoscopic evaluation and treatment of swallowing disorders. New York, Stuttgart: Thieme; 2001: 61-72
    Search in Google Scholar
  • 20 Prosiegel M, Weber S. Dysphagie – Diagnostik und Therapie. Ein Wegweiser für kompetentes Handeln. Berlin, Heidelberg: Springer; 2013
    CrossrefSearch in Google Scholar
  • 21 Aviv JE, Martin JH, Keen MS et al. Air pulse quantification of supraglottic and pharyngeal sensation: a new technique. Ann Otol Rhinol Laryngol 1993; 102: 777-780
    CrossrefPubMedSearch in Google Scholar
  • 22 Suiter DM, Moorhead MK. Effects of flexible fiberoptic endoscopy on pharyngeal swallow physiology. Otolaryngol Head Neck Surg 2007; 137 (06) 956-958
    CrossrefPubMedSearch in Google Scholar
  • 23 Dziewas RT, Warnecke S, Oelenberg I et al. Towards a basic endoscopic assessment of swallowing in acute stroke – development and evaluation of a simple dysphagia score. Cerebrovasc Dis 2008; 26: 41-47
    Search in Google Scholar
  • 24 Warnecke T, Ritter MA, Kroger B et al. Fiberoptic endoscopic Dysphagia severity scale predicts outcome after acute stroke. Cerebrovasc Dis 2009; 28 (03) 283-289
    CrossrefPubMedSearch in Google Scholar
  • 25 Warnecke T, Oelenberg S, Teismann I et al. Endoscopic characteristics and levodopa responsiveness of swallowing function in progressive supranuclear palsy. Mov Disord 2010; 25 (09) 1239-1245
    CrossrefPubMedSearch in Google Scholar
  • 26 Dziewas R, Warnecke T, Ritter M et al. Fatigable swallowing in myasthenia gravis – proposal of a standardized test and report of a case. J Clin Neuromusc Dis 2006; 8: 12-15
    CrossrefPubMedSearch in Google Scholar
  • 27 Warnecke T, Teismann IK, Zimmermann J et al. Fiberoptic endoscopic evaluation of swallowing with simulataneous Tensilon application in diagnosis and therapy of myasthenia gravis. J Neurol 2008; 255: 224-230
    CrossrefPubMedSearch in Google Scholar
  • 28 Warnecke T, Suntrup S, Teismann IK et al. Standardized endoscopic swallowing evaluation for tracheostomy decannulation in critically ill neurologic patients. Crit Care Med 2013; 41 (07) 1728-1732
    CrossrefPubMedSearch in Google Scholar
  • 29 Schröter-Morach H, Graf S. Dysphagiediagnostik durch den HNO-Arzt. HNO 2014; 62: 324-334
    CrossrefPubMedSearch in Google Scholar
  • 30 Deutschmann MW, McDonough A, Dort JC et al. Fiber-optic endoscopic evaluation of swallowing (FEES): predictor of swallowing-related complications in the head and neck cancer population. Head Neck 2013; 35: 974-979
    Search in Google Scholar
  • 31 Schindler A, Denaro N, Russi EG et al. Dysphagia in head and neck cancer patients treated with radiotherapy and systemic therapies: Literature review and consensus. Crit Rev Oncol Hematol 2015; 19: 1040-8428
    PubMedSearch in Google Scholar
  • 32 Logemann JA, Pauloski BR, Rademaker AW et al. Speech and swallow function after tonsil/base of tongue resection with primary closure. J Speech Hear Re 1993; 36: 918-926
    PubMedSearch in Google Scholar
  • 33 Pauloski BR, Rademaker AW, Logemann JA et al. Surgical variables affecting swallowing in patients treated for oral/oropharyngeal cancer. Head Neck 2004; 26: 625-636
    CrossrefPubMedSearch in Google Scholar
  • 34 Haas I, Hauser U, Ganzer U. The dilemma of follow-up in head and neck cancer patients. Eur Arch Otorhinolaryngol 2001; 258: 177-183
    CrossrefPubMedSearch in Google Scholar
  • 35 Sonis ST, Elting LS, Keefe D et al. Mucositis Study Section of the Multinational Association for Supportive Care in Cancer; International Society for Oral Oncology. Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 2004; 100: 1995-2025
    CrossrefPubMedSearch in Google Scholar
  • 36 Pinna R, Campus G, Cumbo E et al. Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage. Ther Clin Risk Manag 2015; 11: 171-188
    PubMedSearch in Google Scholar
  • 37 Rosenbek JC, Robbins JA, Roecker EB. A penetration-aspiration scale. Dysphagia 1996; 11: 93-98
    Search in Google Scholar