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Klinische Neurophysiologie 2009; 40(3): 194-203
DOI: 10.1055/s-0029-1220750
Originalia

© Georg Thieme Verlag KG Stuttgart · New York

Neurologische endoskopische Dysphagiediagnostik – Untersuchungstechnik, Einsatzmöglichkeiten und typische Befunde

Neurological Endoscopic Evaluation of Dysphagia – Technique, Applications and Typical FindingsT. Warnecke1 , E. B. Ringelstein1 , R. Dziewas1
  • 1Klinik und Poliklinik für Neurologie, Universitätsklinikum Münster, Münster
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Publication History

Publication Date:
03 September 2009 (online)

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Zusammenfassung

Die transnasale flexible Videoendoskopie wurde 1988 erstmals als neue Methode zur Untersuchung oropharyngealer Dysphagien beschrieben (Fiberoptic Endoscopic Evaluation of Swallowing=FEES). Mittlerweile hat sie sich neben der radiologischen Untersuchung des Schluckaktes, der sogenannten Videofluoroskopie, als komplementäres apparatives Verfahren zur objektiven Dysphagiediagnostik etabliert. Nach den Leitlinien der Deutschen Gesellschaft für Neurologie ist die Videoendoskopie obligater Bestandteil der Basisdiagnostik neurogener Dysphagien. Neurologische Kliniken verfügen zunehmend über eigene Videoendoskopie-Einheiten. Dieser Übersichtsartikel stellt apparative Voraussetzungen sowie Untersuchungstechnik und Beurteilungskriterien der videoendoskopischen Schluckuntersuchung vor. Es werden typische endoskopische Störungsmuster neurogener Dysphagien von Patienten mit akutem Schlaganfall, amyotropher Lateralsklerose, Myasthenia gravis, frontotemporaler Lobäratrophie und Neurolpetika-induzierter Dysphagie beschrieben. Außerdem werden spezielle Einsatzmöglichkeiten der Videoendoskopie auf Stroke Units und neurologischen Intensivstationen dargestellt.

Abstract

Transnasal flexible videoendoscopy was introduced in 1988 as a new method to assess oropharyngeal dysphagia (Fiberoptic endoscopic evaluation of swallowing=FEES). Today FEES is well established as an apparative tool for objective swallowing studies and is considered to be complementary to videofluoroscopy. Following the guidelines of the German Neurological Society, videoendoscopy is an obligatory part of the diagnostic evaluation in patients with neurogenic dysphagia. To an increasing degree, neurological clinics use their own videoendoscopy units. This review summarises the instrumental requirements as well as the endoscopic procedures and the evaluation criteria of FEES examinations. Typical endoscopic findings in patients with neurogenic dysphagia caused by acute stroke, amyotrophic lateral sclerosis, myasthenia gravis, frontotemporal dementia and neuroleptic-induced dysphagia are described. Furthermore, specific applications of FEES in stroke units and neurological intensive care units are presented.

Schlüsselwörter

neurogene Dysphagie - Videoendoskopie - Dysphagiediagnostik - FEES

Key words

neurogenic dysphagia - videoendoscopy - dysphagia assessment - FEES

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Korrespondenzadresse

Dr. T. Warnecke

Klinik und Poliklinik für Neurologie

Universitätsklinikum Münster

Albert-Schweitzer-Straße 33

48129 Münster

Email: Tobias.Warnecke@ukmuenster.de

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