PMID- 33880400
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210422
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 9
IP  - 4
DP  - 2021 Apr
TI  - Functional endoscopy in neurogenic dysphagia: a feasibility study focusing on the 
      esophageal phase of swallowing.
PG  - E646-E652
LID - 10.1055/a-1380-3224 [doi]
AB  - Background and study aims  Due to demographic transition, neurogenic dysphagia 
      has become an increasingly recognized problem. Patients suffering from dysphagia 
      often get caught between different clinical disciplines. In this study, we 
      implemented a defined examination protocol for evaluating the whole swallowing 
      process by functional endoscopy. Special focus was put on the esophageal phase of 
      swallowing. Patients and methods  This prospective observational 
      multidisciplinary study evaluated 31 consecutive patients with suspected 
      neurogenic dysphagia by transnasal access applying an ultrathin video endoscope. 
      Thirty-one patients with gastroesophageal reflux symptoms were used as a control 
      group. We applied a modified approach including standardized endoscopic positions 
      to compare our findings with fiberoptic endoscopic evaluation of swallowing and 
      high-resolution manometry. The primary outcome measure was feasibility of 
      functional endoscopy. Secondary outcome measures were adverse events (AEs), 
      tolerability, and pathologic endoscopic findings. Results  Functional endoscopy 
      was successfully performed in all patients. No AEs were recorded. A variety of 
      disorders were documented by functional endoscopy: incomplete or delayed closure 
      of the upper esophageal sphincter in retroflex view, clearance disturbance of 
      tubular esophagus, esophageal hyperperistalsis, and hypomotility. Analysis of 
      results obtained with the diagnostic tools showed some discrepancies. 
      Conclusions  By interdisciplinary cooperation with additional assessment of the 
      esophageal phase of deglutition using the innovative method of functional 
      endoscopy, the diagnosis of neurogenic disorders including dysphagia may be 
      significantly improved, leading to a better clinical understanding of complex 
      dysfunctional patterns. To the best of our knowledge, this is the first study to 
      show that a retroflex view of the ultrathin video endoscope within the esophagus 
      can be safely performed. [NCT01995929].
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Ruckert, Jan
AU  - Ruckert J
AD  - Department of Medicine I, Josephs-Hospital Warendorf, Academic Teaching Hospital, 
      University of Muenster, Warendorf, Germany.
FAU - Lenz, Philipp
AU  - Lenz P
AD  - Department of Medicine B, University of Muenster, Muenster, Germany.
AD  - Department of Palliative Medicine, University of Muenster, Muenster, Germany.
FAU - Heinzow, Hauke
AU  - Heinzow H
AD  - Department of Medicine B, University of Muenster, Muenster, Germany.
FAU - Wessling, Johannes
AU  - Wessling J
AD  - Department of Clinical Radiology, University of Muenster, Muenster, Germany.
AD  - Department of Radiology, Clemens Hospital Muenster, Muenster, Germany.
FAU - Warnecke, Tobias
AU  - Warnecke T
AD  - Department of Neurology, University of Muenster, Muenster, Germany.
FAU - Herrmann, Ingo F
AU  - Herrmann IF
AD  - Reflux Center Duesseldorf, ENT, Duesseldorf, Germany.
FAU - Strahl, Michael
AU  - Strahl M
AD  - Reflux Center Duesseldorf, ENT, Duesseldorf, Germany.
FAU - Lenze, Frank
AU  - Lenze F
AD  - Department of Medicine I, Josephs-Hospital Warendorf, Academic Teaching Hospital, 
      University of Muenster, Warendorf, Germany.
FAU - Nowacki, Tobias
AU  - Nowacki T
AD  - Department of Medicine I, Josephs-Hospital Warendorf, Academic Teaching Hospital, 
      University of Muenster, Warendorf, Germany.
AD  - Department of Medicine B, University of Muenster, Muenster, Germany.
FAU - Domagk, Dirk
AU  - Domagk D
AD  - Department of Medicine I, Josephs-Hospital Warendorf, Academic Teaching Hospital, 
      University of Muenster, Warendorf, Germany.
AD  - Department of Medicine B, University of Muenster, Muenster, Germany.
LA  - eng
SI  - ClinicalTrials.gov/NCT01995929
PT  - Journal Article
DEP - 20210415
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC8050561
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2021/04/22 06:00
MHDA- 2021/04/22 06:01
PMCR- 2021/04/01
CRDT- 2021/04/21 06:45
PHST- 2020/08/17 00:00 [received]
PHST- 2020/12/30 00:00 [accepted]
PHST- 2021/04/21 06:45 [entrez]
PHST- 2021/04/22 06:00 [pubmed]
PHST- 2021/04/22 06:01 [medline]
PHST- 2021/04/01 00:00 [pmc-release]
AID - 10.1055/a-1380-3224 [doi]
PST - ppublish
SO  - Endosc Int Open. 2021 Apr;9(4):E646-E652. doi: 10.1055/a-1380-3224. Epub 2021 Apr 
      15.