Subject rehabilitation in secondary dysphagia due to neurodegenerative diseases: a prospective and observation study of twenty patients with fiberoptic endoscopic evaluation of swallowing (fees) and oral-pharyngo-esophageal scintigraphy (OPES)

Many neurological diseases alter swallowing mechanism causing dysphagia. After clinical evaluation (such as Dysphagia Outcome and Severity Scale-DOSS), dysphagia must be confirmed by instrumental examinations such as Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Oral-Pharyngo-Esophageal Scintigraphy (OPES). To prevent complications (malnutrition, dehydration and abingestis pneumonia), identifying as early as possible the onset of dysphagia is fundamental to set individual rehabilitation program. In this prospective and observational study, we evaluated data modification of DOSS, FEES and OPES parameters in 20 patients with dysphagia due to neurodegenerative diseases treated with rehabilitation. 20 patients (11 female and 9 male, middle age 55,65± 18,16 years) were enrolled. Inclusion criteria were diagnosis of neurodegenerative pathology and dysphagia for solids and semisolids, and mild dysphagia for liquids. Data were performed at enrollement (t0) and after the therapy (lasting on average 238.40 days). At the end of study, 85% of patients were stable, 10% worsened and 5% improved according to DOSS scale. Considering data of FEES and OPES, we demonstrated a different trend depending on the values examined. FEES and OPES must be complementary because FEES allows us to evaluate well the stagnation of saliva and bolus of different consistency, while OPES provides us functional analyses of swallowing calculating the oral, pharyngeal and esophageal transit times and the% of retention indexes of the oral pharynx and esophagus. Rehabilitation treatment does not involve a return to normal swallowing but a delay in the evolution of dysphagia caused by neurodegenerative diseases