ABSTRACT
OBJECTIVES: The purpose of this study was to evaluate the effectiveness of fiberoptic endoscopic evaluation of swallowing (FEES) and the modified barium swallow test (MBST) in patients with dysphagia. PATIENTS AND METHODS: Eighty patients with dysphagia were evaluated in three groups consisting of 27 patients with oral, pharyngeal, or esophageal masses; 26 patients with neurogenic dysphagia; and 27 patients with no distinct pathology. All the patients underwent FEES and MBST to examine elevation of the soft palate, nasal regurgitation, pharyngeal residue, penetration, aspiration, and pooling of secretions in the pyriform sinus and vallecula. RESULTS: In neurogenic dysphagia, MBST was more efficacious in detecting aspiration and pooling in the vallecula (p<0.05). Evaluation of the internal anatomy, visualization of masses, and laryngopharyngeal sensory discrimination were only possible with the FEES. On the other hand, evaluation of the elevation of the larynx and the hyoid, the relaxation of the upper esophageal sphincter, and the oral phase of swallowing, and the detection of esophageal pathologies were only possible with the MBST. CONCLUSION: The leading advantages of the two evaluation techniques seem to lie in the detection of aspiration for the FEES, and dynamic evaluation of the oral and esophageal phases of swallowing for the MBST.
