Skip to main content
Erschienen in: Der Nervenarzt 8/2014

01.08.2014 | Aktuelles aus Diagnostik und Therapie

FEES für neurogene Dysphagien

Ausbildungscurriculum der Deutschen Gesellschaft für Neurologie und Deutschen Schlaganfall-Gesellschaft

verfasst von: Prof. Dr. R. Dziewas, J. Glahn, C. Helfer, G. Ickenstein, J. Keller, S. Lapa, C. Ledl, B. Lindner-Pfleghar, D. Nabavi, M. Prosiegel, A. Riecker, S. Stanschus, T. Warnecke, O. Busse

Erschienen in: Der Nervenarzt | Ausgabe 8/2014

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die neurogene Dysphagie gehört zu den häufigsten und zugleich bedrohlichsten Symptomen einer Vielzahl neurologischer Erkrankungen, wie etwa dem Schlaganfall, den Parkinson-Syndromen und verschiedenen neuromuskulären Erkrankungen. Die flexible endoskopische Evaluation des Schluckakts (FEES) stellt heute in Deutschland die wahrscheinlich am häufigsten eingesetzte Methode zur objektiven Beurteilung des Schluckakts dar. Mithilfe der FEES werden die Effektivität und Sicherheit des Schluckakts beurteilt, geeignete Nahrungskonsistenzen bzw. Ernährungsformen festgelegt und der Einsatz von therapeutischen Manövern evaluiert. Aus der Datenlage geht zudem hervor, dass die FEES eine sehr gut verträgliche und sichere Untersuchung ist. Trotz des großen Bedarfs an qualifizierter Dysphagiediagnostik im klinischen Alltag wird diese Untersuchungstechnik bisher nicht systematisch vermittelt. Das in diesem Beitrag vorgestellte strukturierte Ausbildungscurriculum soll diese Lücke schließen und dazu beitragen, eine hohe FEES-Qualität sicherzustellen. Da das Dysphagiemanagement weit über das neurologische Fachgebiet hinausgeht, richtet sich dieses Curriculum auch an andere Mediziner, Logopäden, klinische Linguisten und Sprachtherapeuten mit spezieller Dysphagieexpertise.
Literatur
1.
Zurück zum Zitat American Speech-Language-Hearing Association (2002) Knowledge and skills for speech-language pathologists performing endoscopic assessment of swallowing functions. http://www.asha.org/docs/pdf/KS2002-00069.pdf. Zugegriffen 17 Juni 2014 American Speech-Language-Hearing Association (2002) Knowledge and skills for speech-language pathologists performing endoscopic assessment of swallowing functions. http://​www.​asha.​org/​docs/​pdf/​KS2002-00069.​pdf.​ Zugegriffen 17 Juni 2014
2.
Zurück zum Zitat American Speech-Language-Hearing Association (2005) The role of the speech-language pathologist in the performance and interpretation of swallowing: position statement. http://www.asha.org/policy/PS2005-00112/. Zugegriffen 17 Juni 2014 American Speech-Language-Hearing Association (2005) The role of the speech-language pathologist in the performance and interpretation of swallowing: position statement. http://​www.​asha.​org/​policy/​PS2005-00112/​.​ Zugegriffen 17 Juni 2014
3.
Zurück zum Zitat Aviv JE, Kaplan ST, Langmore SE (2001) The safety of endoscopic swallowing evaluations. In: Langmore SE (Hrsg) Endoscopic evaluation and treatment of swallowing disorders. Thieme, New York, S 235–242 Aviv JE, Kaplan ST, Langmore SE (2001) The safety of endoscopic swallowing evaluations. In: Langmore SE (Hrsg) Endoscopic evaluation and treatment of swallowing disorders. Thieme, New York, S 235–242
4.
Zurück zum Zitat Aviv JE, Kaplan ST, Thomson JE et al (2000) The safety of flexible endoscopic evaluation of swallowing with sensory testing (FEESST): an analysis of 500 consecutive evaluations. Dysphagia 15:39–44PubMedCrossRef Aviv JE, Kaplan ST, Thomson JE et al (2000) The safety of flexible endoscopic evaluation of swallowing with sensory testing (FEESST): an analysis of 500 consecutive evaluations. Dysphagia 15:39–44PubMedCrossRef
5.
Zurück zum Zitat Carnaby-Mann G, Lenius K (2008) The bedside examination in dysphagia. Phys Med Rehabil Clin N Am 19:747–768PubMedCrossRef Carnaby-Mann G, Lenius K (2008) The bedside examination in dysphagia. Phys Med Rehabil Clin N Am 19:747–768PubMedCrossRef
6.
Zurück zum Zitat Cohen MA, Setzen M, Perlman PW et al (2003) The safety of flexible endoscopic evaluation of swallowing with sensory testing in an outpatient otolaryngology setting. Laryngoscope 113:21–24PubMedCrossRef Cohen MA, Setzen M, Perlman PW et al (2003) The safety of flexible endoscopic evaluation of swallowing with sensory testing in an outpatient otolaryngology setting. Laryngoscope 113:21–24PubMedCrossRef
7.
Zurück zum Zitat Deutschmann MW, McDonough A, Dort JC et al (2012) Fiber-optic endoscopic evaluation of swallowing (FEES): predictor of swallowing-related complications in the head and neck cancer population. Head Neck 35:974–979PubMedCrossRef Deutschmann MW, McDonough A, Dort JC et al (2012) Fiber-optic endoscopic evaluation of swallowing (FEES): predictor of swallowing-related complications in the head and neck cancer population. Head Neck 35:974–979PubMedCrossRef
8.
9.
Zurück zum Zitat Dziewas R, Schilling M, Konrad C et al (2003) Placing nasogastric tubes in stroke patients with dysphagia: efficiency and tolerability of the reflex placement. J Neurol Neurosurg Psychiatry 74:1429–1431PubMedCentralPubMed Dziewas R, Schilling M, Konrad C et al (2003) Placing nasogastric tubes in stroke patients with dysphagia: efficiency and tolerability of the reflex placement. J Neurol Neurosurg Psychiatry 74:1429–1431PubMedCentralPubMed
10.
Zurück zum Zitat Dziewas R, Warnecke T, Oelenberg S et al (2008) Towards a basic endoscopic assessment of swallowing in acute stroke – development and evaluation of a simple dysphagia score. Cerebrovasc Dis 26:41–47PubMedCrossRef Dziewas R, Warnecke T, Oelenberg S et al (2008) Towards a basic endoscopic assessment of swallowing in acute stroke – development and evaluation of a simple dysphagia score. Cerebrovasc Dis 26:41–47PubMedCrossRef
11.
Zurück zum Zitat Grob D, Arsura L, Brunner NG et al (1987) The course of myasthenia gravis and therapies affecting outcome. Ann N Y Acad Sci 505:472–499PubMedCrossRef Grob D, Arsura L, Brunner NG et al (1987) The course of myasthenia gravis and therapies affecting outcome. Ann N Y Acad Sci 505:472–499PubMedCrossRef
12.
Zurück zum Zitat Hafner G, Neuhuber A, Hirtenfelder S et al (2008) Fiberoptic endoscopic evaluation of swallowing in intensive care unit patients. Eur Arch Otorhinolaryngol 265:441–446PubMedCentralPubMedCrossRef Hafner G, Neuhuber A, Hirtenfelder S et al (2008) Fiberoptic endoscopic evaluation of swallowing in intensive care unit patients. Eur Arch Otorhinolaryngol 265:441–446PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Hoffmann S, Malzahn U, Harms H et al (2012) Development of a clinical score (A2DS2) to predict pneumonia in acute ischemic stroke. Stroke 43:2617–2623PubMedCrossRef Hoffmann S, Malzahn U, Harms H et al (2012) Development of a clinical score (A2DS2) to predict pneumonia in acute ischemic stroke. Stroke 43:2617–2623PubMedCrossRef
14.
Zurück zum Zitat Horner J, Alberts MJ, Dawson NV et al (1994) Swallowing in Alzheimer’s disease. Alzheimer Dis Assoc Disord 8:177–189PubMedCrossRef Horner J, Alberts MJ, Dawson NV et al (1994) Swallowing in Alzheimer’s disease. Alzheimer Dis Assoc Disord 8:177–189PubMedCrossRef
15.
Zurück zum Zitat Kelly AM, Drinnan MJ, Leslie P (2007) Assessing penetration and aspiration: how do videofluoroscopy and fiberoptic endoscopic evaluation of swallowing compare? Laryngoscope 117:1723–1727PubMedCrossRef Kelly AM, Drinnan MJ, Leslie P (2007) Assessing penetration and aspiration: how do videofluoroscopy and fiberoptic endoscopic evaluation of swallowing compare? Laryngoscope 117:1723–1727PubMedCrossRef
16.
Zurück zum Zitat Kelly AM, Hydes K, McLaughlin C et al (2007) Fibreoptic endoscopic evaluation of swallowing (FEES): the role of speech and language therapy. RCSLT Policy Statement. http://www.rcslt.org/members/publications/publications2/fees_policy_update. Zugegriffen 17 Juni 2014 Kelly AM, Hydes K, McLaughlin C et al (2007) Fibreoptic endoscopic evaluation of swallowing (FEES): the role of speech and language therapy. RCSLT Policy Statement. http://​www.​rcslt.​org/​members/​publications/​publications2/​fees_​policy_​update.​ Zugegriffen 17 Juni 2014
17.
Zurück zum Zitat Kelly AM, Leslie P, Beale T et al (2006) Fibreoptic endoscopic evaluation of swallowing and videofluoroscopy: does examination type influence perception of pharyngeal residue severity? Clin Otolaryngol 31:425–432PubMedCrossRef Kelly AM, Leslie P, Beale T et al (2006) Fibreoptic endoscopic evaluation of swallowing and videofluoroscopy: does examination type influence perception of pharyngeal residue severity? Clin Otolaryngol 31:425–432PubMedCrossRef
18.
Zurück zum Zitat Kühnlein P, Gdynia HJ, Sperfeld AD et al (2008) Diagnosis and treatment of bulbar symptoms in amyotrophic lateral sclerosis. Nat Clin Pract Neurol 4:366–374PubMedCrossRef Kühnlein P, Gdynia HJ, Sperfeld AD et al (2008) Diagnosis and treatment of bulbar symptoms in amyotrophic lateral sclerosis. Nat Clin Pract Neurol 4:366–374PubMedCrossRef
19.
Zurück zum Zitat Langmore SE (2001) Endoscopic evaluation and treatment of swallowing disorders. Thieme, New York Langmore SE (2001) Endoscopic evaluation and treatment of swallowing disorders. Thieme, New York
20.
Zurück zum Zitat Langmore SE (2003) Evaluation of oropharyngeal dysphagia: which diagnostic tool is superior? Curr Opin Otolaryngol Head Neck Surg 11:485–489PubMedCrossRef Langmore SE (2003) Evaluation of oropharyngeal dysphagia: which diagnostic tool is superior? Curr Opin Otolaryngol Head Neck Surg 11:485–489PubMedCrossRef
21.
Zurück zum Zitat Langmore SE, Aviv JE (2001) Endoscopic procedures to evaluate oropharyngeal swallowing. In: Langmore SE (Hrsg) Endoscopic evaluation and treatment of swallowing disorders. Thieme, New York, S 73–100 Langmore SE, Aviv JE (2001) Endoscopic procedures to evaluate oropharyngeal swallowing. In: Langmore SE (Hrsg) Endoscopic evaluation and treatment of swallowing disorders. Thieme, New York, S 73–100
22.
Zurück zum Zitat Langmore SE, Olney RK, Lornen-Hoerth C et al (2007) Dysphagia in patients with frontotemporal lobar dementia. Arch Neurol 64:58–62PubMedCrossRef Langmore SE, Olney RK, Lornen-Hoerth C et al (2007) Dysphagia in patients with frontotemporal lobar dementia. Arch Neurol 64:58–62PubMedCrossRef
23.
Zurück zum Zitat Langmore SE, Schatz K, Olsen N (1988) Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 2:216–219PubMedCrossRef Langmore SE, Schatz K, Olsen N (1988) Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 2:216–219PubMedCrossRef
24.
Zurück zum Zitat Leder SB (1997) A comment on „Modified barium swallow: clinical and radiographic correlation and relation to feeding recommendations“. Dysphagia 12:52–54PubMedCrossRef Leder SB (1997) A comment on „Modified barium swallow: clinical and radiographic correlation and relation to feeding recommendations“. Dysphagia 12:52–54PubMedCrossRef
25.
Zurück zum Zitat Leder SB (1999) Fiberoptic endoscopic evaluation of swallowing in patients with acute traumatic brain injury. J Head Trauma Rehabil 14:448–553PubMedCrossRef Leder SB (1999) Fiberoptic endoscopic evaluation of swallowing in patients with acute traumatic brain injury. J Head Trauma Rehabil 14:448–553PubMedCrossRef
26.
Zurück zum Zitat Leder SB, Novella S, Patwa H (2004) Use of fiberoptic endoscopic evaluation of swallowing (FEES) in patients with amyotrophic lateral sclerosis. Dysphagia 19:177–181PubMedCrossRef Leder SB, Novella S, Patwa H (2004) Use of fiberoptic endoscopic evaluation of swallowing (FEES) in patients with amyotrophic lateral sclerosis. Dysphagia 19:177–181PubMedCrossRef
27.
Zurück zum Zitat Leder SB, Sasaki CT, Burrell MI (1998) Fiberoptic endoscopic evaluation of dysphagia to identify silent aspiration. Dysphagia 13:19–21PubMedCrossRef Leder SB, Sasaki CT, Burrell MI (1998) Fiberoptic endoscopic evaluation of dysphagia to identify silent aspiration. Dysphagia 13:19–21PubMedCrossRef
28.
Zurück zum Zitat Macht M, Wimbish T, Clark BJ et al (2011) Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. Crit Care 15:R231PubMedCentralPubMedCrossRef Macht M, Wimbish T, Clark BJ et al (2011) Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. Crit Care 15:R231PubMedCentralPubMedCrossRef
29.
Zurück zum Zitat Mackay LE, Morgan AS, Bernstein BA (1999) Factors affecting oral feeding with severe traumatic brain injury. J Head Trauma Rehabil 14:435–447PubMedCrossRef Mackay LE, Morgan AS, Bernstein BA (1999) Factors affecting oral feeding with severe traumatic brain injury. J Head Trauma Rehabil 14:435–447PubMedCrossRef
30.
Zurück zum Zitat Martino R, Foley N, Bhogal S et al (2005) Dysphagia after stroke – incidence, diagnosis, and pulmonary complications. Stroke 36:2756–2763PubMedCrossRef Martino R, Foley N, Bhogal S et al (2005) Dysphagia after stroke – incidence, diagnosis, and pulmonary complications. Stroke 36:2756–2763PubMedCrossRef
31.
Zurück zum Zitat McCullough GH, Rosenbek JC, Wertz RT et al (2005) Utility of clinical swallowing examination measures for detecting aspiration post-stroke. J Speech Lang Hear Res 48:1280–1293PubMedCrossRef McCullough GH, Rosenbek JC, Wertz RT et al (2005) Utility of clinical swallowing examination measures for detecting aspiration post-stroke. J Speech Lang Hear Res 48:1280–1293PubMedCrossRef
32.
Zurück zum Zitat Miller N, Noble E, Jones D et al (2006) Hard to swallow: dysphagia in Parkinson’s disease. Age Ageing 35:614–618PubMedCrossRef Miller N, Noble E, Jones D et al (2006) Hard to swallow: dysphagia in Parkinson’s disease. Age Ageing 35:614–618PubMedCrossRef
33.
Zurück zum Zitat Morgan AS, Mackay LE (1999) Causes and complications associated with swallowing disorders in traumatic brain injury. J Head Trauma Rehabil 14:454–461PubMedCrossRef Morgan AS, Mackay LE (1999) Causes and complications associated with swallowing disorders in traumatic brain injury. J Head Trauma Rehabil 14:454–461PubMedCrossRef
34.
Zurück zum Zitat Mulcahy KP, Langdon PC, Mastaglia F (2012) Dysphagia in inflammatory myopathy: self-report, incidence, and prevalence. Dysphagia 27:64–69PubMedCrossRef Mulcahy KP, Langdon PC, Mastaglia F (2012) Dysphagia in inflammatory myopathy: self-report, incidence, and prevalence. Dysphagia 27:64–69PubMedCrossRef
35.
Zurück zum Zitat Muller J, Wenning GK, Verny M et al (2001) Progression of dysarthria and dysphagia in postmortem-confirmed parkinsonian disorder. Arch Neurol 58:259–264PubMedCrossRef Muller J, Wenning GK, Verny M et al (2001) Progression of dysarthria and dysphagia in postmortem-confirmed parkinsonian disorder. Arch Neurol 58:259–264PubMedCrossRef
36.
Zurück zum Zitat O’Dongue S, Bagnall A (1999) Videofluoroscopic evaluation in the assessment of swallowing disorders in pediatric and adult populations. Folia Phoniatr Logop 51:158–171CrossRef O’Dongue S, Bagnall A (1999) Videofluoroscopic evaluation in the assessment of swallowing disorders in pediatric and adult populations. Folia Phoniatr Logop 51:158–171CrossRef
37.
Zurück zum Zitat Prosiegel M, Riecker A, Weinert M et al (2012) Dysphagiemanagement in der akuten Schlaganfallphase. Nervenarzt 83:1590–1599PubMedCrossRef Prosiegel M, Riecker A, Weinert M et al (2012) Dysphagiemanagement in der akuten Schlaganfallphase. Nervenarzt 83:1590–1599PubMedCrossRef
38.
Zurück zum Zitat Suh MK, Kim H, Na DL (2009) Dysphagia in patients with dementia: Alzheimer versus vascular. Alzheimer Dis Assoc Disord 23:178–184PubMedCrossRef Suh MK, Kim H, Na DL (2009) Dysphagia in patients with dementia: Alzheimer versus vascular. Alzheimer Dis Assoc Disord 23:178–184PubMedCrossRef
39.
Zurück zum Zitat Suntrup S, Meisel A, Dziewas R et al (2012) Dysphagiediagnostik und -therapie des akuten Schlaganfalls – eine bundesweite Erhebung auf zertifizierten Stroke Units. Nervenarzt. DOI 10.1007/s00115-012-3611-9 Suntrup S, Meisel A, Dziewas R et al (2012) Dysphagiediagnostik und -therapie des akuten Schlaganfalls – eine bundesweite Erhebung auf zertifizierten Stroke Units. Nervenarzt. DOI 10.1007/s00115-012-3611-9
40.
Zurück zum Zitat Suntrup S, Warnecke T, Kemmling A et al (2011) Dysphagia in patients with acute striatocapsular hemorrhage. J Neurol 259:93–99PubMedCrossRef Suntrup S, Warnecke T, Kemmling A et al (2011) Dysphagia in patients with acute striatocapsular hemorrhage. J Neurol 259:93–99PubMedCrossRef
41.
Zurück zum Zitat Tolep K, Getch CL, Criner GJ (1996) Swallowing dysfunction in patients receiving prolonged mechanical ventilation. Chest 109:167–172PubMedCrossRef Tolep K, Getch CL, Criner GJ (1996) Swallowing dysfunction in patients receiving prolonged mechanical ventilation. Chest 109:167–172PubMedCrossRef
42.
Zurück zum Zitat Warnecke T, Oelenberg S, Teismann I et al (2010) Endoscopic characteristics and levodopa responsiveness of swallowing function in progressive supranuclear palsy. Mov Disord 25:1239–1245PubMedCrossRef Warnecke T, Oelenberg S, Teismann I et al (2010) Endoscopic characteristics and levodopa responsiveness of swallowing function in progressive supranuclear palsy. Mov Disord 25:1239–1245PubMedCrossRef
43.
Zurück zum Zitat Warnecke T, Oelenberg S, Teismann I et al (2009) Dysphagia in X-linked bulbospinal muscular atrophy (Kennedy disease). Neuromuscul Disord 19:704–708PubMedCrossRef Warnecke T, Oelenberg S, Teismann I et al (2009) Dysphagia in X-linked bulbospinal muscular atrophy (Kennedy disease). Neuromuscul Disord 19:704–708PubMedCrossRef
44.
Zurück zum Zitat Warnecke T, Ringelstein EB, Dziewas R (2009) Neurologische endoskopische Dysphagiediagnostik – Untersuchungstechnik, Einsatzmöglichkeiten und typische Befunde. Klin Neurophysiol 40:194–203CrossRef Warnecke T, Ringelstein EB, Dziewas R (2009) Neurologische endoskopische Dysphagiediagnostik – Untersuchungstechnik, Einsatzmöglichkeiten und typische Befunde. Klin Neurophysiol 40:194–203CrossRef
45.
Zurück zum Zitat Warnecke T, Teismann I, Oelenberg S et al (2009) The safety of fiberoptic endoscopic evaluation of swallowing in acute stroke patients. Stroke 40:482–486PubMedCrossRef Warnecke T, Teismann I, Oelenberg S et al (2009) The safety of fiberoptic endoscopic evaluation of swallowing in acute stroke patients. Stroke 40:482–486PubMedCrossRef
46.
Zurück zum Zitat Willging JP, Thompson DM (2005) Pediatric FEESST: fiberoptic endoscopic evaluation of swallowing with sensory testing. Curr Gastroenterol Rep 7:240–243PubMedCrossRef Willging JP, Thompson DM (2005) Pediatric FEESST: fiberoptic endoscopic evaluation of swallowing with sensory testing. Curr Gastroenterol Rep 7:240–243PubMedCrossRef
47.
Zurück zum Zitat Wu CH, Hsiao TY, C CJ et al (1997) Evaluation of swallowing safety with fiberoptic endoscope: comparison with videofluoroscopic technique. Laryngoscope 107:396–401PubMedCrossRef Wu CH, Hsiao TY, C CJ et al (1997) Evaluation of swallowing safety with fiberoptic endoscope: comparison with videofluoroscopic technique. Laryngoscope 107:396–401PubMedCrossRef
Metadaten
Titel
FEES für neurogene Dysphagien
Ausbildungscurriculum der Deutschen Gesellschaft für Neurologie und Deutschen Schlaganfall-Gesellschaft
verfasst von
Prof. Dr. R. Dziewas
J. Glahn
C. Helfer
G. Ickenstein
J. Keller
S. Lapa
C. Ledl
B. Lindner-Pfleghar
D. Nabavi
M. Prosiegel
A. Riecker
S. Stanschus
T. Warnecke
O. Busse
Publikationsdatum
01.08.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Der Nervenarzt / Ausgabe 8/2014
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI
https://doi.org/10.1007/s00115-014-4114-7

Weitere Artikel der Ausgabe 8/2014

Der Nervenarzt 8/2014 Zur Ausgabe

Mitteilungen der Schlaganfallgesellschaft

Mitteilungen der Schlaganfallgesellschaft 8/2014

Mitteilungen der DGPPN

Mitteilungen der DGPPN 8/2014