Fiberoptic Endoscopic Evaluation of Swallowing (FEES)纤维内镜评估吞咽（费用）.pptVIP

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2018-06-23 发布于浙江
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Fiberoptic Endoscopic Evaluation of Swallowing (FEES)纤维内镜评估吞咽（费用）.ppt

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Fiberoptic Endoscopic Evaluation of Swallowing (FEES)纤维内镜评估吞咽（费用）

Fiberoptic Endoscopic Evaluation of Swallowing(FEES) Jaclyn Weiss It Is Also Called: Videoendoscopy Flexible fiberoptic examination of swallowing Endoscopy What Is It Used For? FEES allows for the direct viewing of swallowing function when regular food materials are eaten. It identifies functional abnormalities that may occur and is used in practice swallows to help determine the safest position and food texture to maximize nutritional status and eliminate the risk of aspiration and unsafe swallowing. It assess the existence of Dysphagia or swallowing disorders. How Does It Work? A flexible fiberoptic laryngoscope is passed through the nasal cavity and placed in the pharynx at the level of the soft palate. In order to make the patient more comfortable, the inside of the nose is coated with a gel to reduce the sensation of the endoscope being passed. Once the patient is comfortable, he or she is given foods or liquids that are tinted with food dye so the examiner can follow their passage. What To Look For: The examiner then watches the material as it passes from the base of the tongue into the esophagus (swallowing passageway). Careful observation is made of foods and liquids that are retained in various areas. Deviation of the bolus (food or liquid) from its normal path during the swallow is also observed. Abnormal Findings Include: Premature Spillage: material enters the hypopharynx before the laryngeal swallow is initiated; can pool in the vallecula, pyriform sinuses and posterior larynx. Residue: coating of the walls in the hypopharynx that can be penetrated or aspirated. Penetration: bolus sits on the superior surface of the larynx or is above the vocal folds Aspiration: bolus passes below the true vocal folds Other Things to Look For: Laryngeal inflammation Vocal fold mobility Glottal closure Pharyngeal contraction Speed of the swallow Secretion management Fatigue Incoordination of breathing and swallowing Incoordination of bolus flow and air