Skip to main content
SpringerLink
Log in

Diagnostik

  • Chapter
  • First Online:
Dysphagie

Part of the book series: Praxiswissen Logopädie ((PRAXISWISSEN))

  • 5355 Accesses

Zusammenfassung

Dieses Kapitel beschäftigt sich mit der Dokumentation und der klinischen bzw. apparativen Diagnostik von Dysphagien. Zunächst wird auf Klassifikationssysteme des deutschen Gesundheitssystems eingegangen, in denen Dysphagien und assoziierte Störungen (wie Sondenernährung und Trachealkanülen) erfasst bzw. dokumentiert werden können: ICF, ICD-10-GM-2017, OPS- und DRG-Katalog; dabei wird auch der Stellenwert von Dysphagien im Rahmen des Bundesteilnahmegesetzes und der reformierten Pflegeversicherung berücksichtigt. Es folgt ein Abschnitt, in dem sehr ausführlich eingegangen wird auf verschiedene Screeningverfahren (insbesondere bezüglich Dysphagien und Aspirationen in der akuten Schlaganfallphase) und auf die ausführliche klinische Schluckuntersuchung. Danach werden die drei wichtigsten apparativen Verfahren der Dysphagiologie ausführlich dargestellt: die Videoendoskopie und die Videofluoroskopie des Schluckens sowie die Manometrie von Pharynx und Ösophagus; es werden jeweils Indikationen, Methodik, Nebenwirkungen, Stellenwert in Diagnostik und Therapie sowie Vor- bzw. Nachteile der einzelnen Verfahren erörtert. Der letzte Abschnitt befasst sich mit der Bedeutung klinischer und apparativer Diagnostikinstrumente für die Verlaufskontrolle; dabei geht es unter anderem um Fragen, wann welche Verlaufsdiagnostik indiziert ist, nach welchen Kriterien sie bewertet wird und welche Konsequenzen sich aus den Befunden ergeben

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 44.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  • Albeldawi M, Makkar R (2012) Barium aspiration. N Engl J Med 366: 1038

    Google Scholar 

  • Alfonsi E, Merlo IM, Ponzio M, Montomoli C, Tassorelli C, Biancardi C, Lozza A, Martignoni E (2010) An electrophysiological approach to the diagnosis of neurogenic dysphagia: implications for botulinum toxin treatment. J Neurol Neurosurg Psychiatry 81: 54–60

    Article  CAS  Google Scholar 

  • Aviv JE, Kaplan ST, Thomson JE, Spitzer J, Diamond B, Close LG (2000) The safety of flexible endoscopic evaluation of swallowing with sensory testing (FEESST): an analysis of 500 consecutive evaluations. Dysphagia 15: 39–44

    Article  CAS  Google Scholar 

  • Bartolome G (2018) Grundlagen der funktionellen Dysphagietherapie (FDT). In: Bartolome G, Schröter-Morasch H (Hrsg) Schluckstörungen: Diagnostik und Rehabilitation. Urban & Fischer, München (im Druck)

    Google Scholar 

  • Belafsky PC, Blumenfeld L, LePage A, Nahrstedt K (2003) The accuracy of the modified Evan’s blue dye test in predicting aspiration. Laryngoscope 113: 1969–1972

    Article  Google Scholar 

  • Birkmamm U, Kley C (2015) FEES: Die funktionelle Schluckuntersuchung in der Neurologie – ein Videolehrgang. Hippocampus-Verlag, Bad Honnef

    Google Scholar 

  • Bonilha HS, Humphries K, Blair J, Hill EG, McGrattan K, Carnes B, Huda W, Martin-Harris B (2013) Radiation exposure time during MBSS: influence of swallowing impairment severity, medical diagnosis, clinician experience, and standardized protocol use. Dysphagia 28: 77–85

    Article  Google Scholar 

  • Bray BD, Smith CJ, Cloud GC, Enderby P, James M, Paley L, Tyrrell PJ, Wolfe CD, Rudd AG; SSNAP Collaboration (2017) The association between delays in screening for and assessing dysphagia after acute stroke, and the risk of stroke-associated pneumonia. J Neurol Neurosurg Psychiatry 88: 25–30L

    Article  Google Scholar 

  • Bülow M (2018) The therapeutic swallowing study. In Ekberg (Hrsg) Dysphagia. Springer, Berlin, Heidelberg (im Druck)

    Google Scholar 

  • Bundesministerium für Gesundheit (2017) Praxisseiten Pflege. https://www.bundesgesundheitsministerium.de/themen/pflege/praxisseiten-pflege/praxisseiten-pflege-zum-download/einzelseiten.html. Zugegriffen: 14.12.2017

  • Castell JA, Castell DO (1993) Modern solid state computerized manometry of the pharyngoesophageal segment. Dysphagia 8: 270–275

    Article  CAS  Google Scholar 

  • Colodny N (2002) Interjudge and intrajudge reliabilities in fiberoptic endoscopic evaluation of swallowing (FEES) using the penetration-aspiration scale: a replication study. Dysphagia 17: 308–315

    Article  Google Scholar 

  • Daniels SK, McAdam CP, Brailey K, Foundas AL (1997) Clinical assessment of swallowing and prediction of dysphagia severity. Am J Speech Lang Pathol 6: 17–24

    Article  Google Scholar 

  • Daniels SK, Anderson JA, Wilson PC (2012) Valid items for screening dysphagia risk in patients with stroke: a systematic review. Stroke 43: 892–897

    Article  Google Scholar 

  • Davies AE, Kidd D, Stone SP, MacMahon J (1995) Pharyngeal sensation and gag reflex in healthy subjects. Lancet 345: 487–488

    Article  CAS  Google Scholar 

  • Dong Y, Zhang CJ, Shi J, Deng J, Lan CN (2016) Clinical application of ICF key codes to evaluate patients with dysphagia following stroke. Medicine (Baltimore) 95: e4479

    Article  Google Scholar 

  • Donovan NJ, Daniels SK, Edmiaston J, Weinhardt J, Summers D, Mitchell PH; American Heart Association Council on Cardiovascular Nursing and Stroke Council (2013) Dysphagia screening: state of the art: invitational conference proceeding from the State-of-the-Art Nursing Symposium, International Stroke Conference 2012 44: e24–31

    Google Scholar 

  • Donzelli J, Brady S, Wesling M, Craney M (2001) Simultaneous modified Evans blue dye procedure and video nasal endoscopic evaluation of the swallow. Laryngoscope 111: 1746–1750

    Article  CAS  Google Scholar 

  • Dziewas R, Glahn J, Helfer C, Ickenstein G, Keller J, Lapa S, Ledl C, Lindner-Pfleghar B, Nabavi D, Prosiegel M, Riecker A, Stanschus S, Warnecke T, Busse O (2014) FEES for neurogenic dysphagia: training curriculum of the German Society of Neurology and the German Stroke Society. Nervenarzt 85: 1006–1015

    Article  CAS  Google Scholar 

  • Dziewas R, Warnecke T, Olenberg S, Teismann I, Zimmermann J, Kramer C, Ritter M, Ringelstein EB, Schabitz WR (2008) Towards a basic endoscopic assessment of swallowing in acute stroke – development and evaluation of a simple dysphagia score. Cerebrovasc Dis 26: 41–47

    Article  Google Scholar 

  • Edmiaston J, Conno LT, Steger-May K, Ford AL (2014) A simple bedside stroke dysphagia screen, validated against videofluoroscopy, detects dysphagia and aspiration with high sensitivity. J Stroke Cerebrovasc Dis 23: 712–716

    Article  Google Scholar 

  • Gates J, Hartnell GG, Gramigna GD (2006) Videofluoroscopy and swallowing studies for neurologic disease: a primer. Radiographics 26: e22

    Article  Google Scholar 

  • Heuschmann PU, Kolominsky-Rabas PL, Misselwitz B, Hermanek P, Leffmann C, Janzen RW, Rother J, Buecker-Nott HJ, Berger K; German Stroke Registers Study Group (2004) Predictors of in-hospital mortality and attributable risks of death after ischemic stroke: the German Stroke Registers Study Group. Arch Intern Med 164: 1761–1768

    Google Scholar 

  • Hey C, Pluschinski P, Zaretsky Y, Almahameed A, Hirth D, Vaerst B, Wagenblast J, Stöver T (2014) Penetrations-Aspirations-Skala nach Rosenbek. HNO 62: 276–281

    Article  CAS  Google Scholar 

  • Hinchey JA, Shephard T, Furie K, Smith D, Wang D, Tonn S; Stroke Practice Improvement Network Investigators (2005) Formal dysphagia screening protocols prevent pneumonia. Stroke 36: 1972–1976

    PubMed  Google Scholar 

  • Hirst LJ, Ford GA, Gibson GJ, Wilson JA (2002) Swallow-induced alterations in breathing in normal older people. Dysphagia 17: 152–161

    Article  Google Scholar 

  • Huckabee ML, Lamvik K, Jones R (2014) Pharyngeal mis-sequencing in dysphagia: characteristics, rehabilitative response, and etiological speculation. J Neurol Sci 343: 153–158

    Article  CAS  Google Scholar 

  • Ishida R, Palmer JB, Hiiemae KM (2002) Hyoid motion during swallowing: factors affecting forward and upward displacement. Dysphagia 17: 262–272

    Article  Google Scholar 

  • Keage M, Delatycki M, Corben L, Vogel A (2015) A systematic review of self-reported swallowing assessments in progressive neurological disorders. Dysphagia 30: 27–46

    Article  Google Scholar 

  • Kelly AM, Leslie P, Beale T, Payten C, Drinnan MJ (2006) Fibreoptic endoscopic evaluation of swallowing and videofluoroscopy: does examination type influence perception of pharyngeal residue severity? Clin Otolaryngol 31: 425–432

    Article  CAS  Google Scholar 

  • Kelly AM, Drinnan MJ, Leslie P (2007) Assessing penetration and aspiration: how do videofluoroscopy and fiberoptic endoscopic evaluation of swallowing compare? Laryngoscope 117: 1723–1727

    Article  Google Scholar 

  • Kim Y, McCullough GH, Asp CW (2005) Temporal measurements of pharyngeal swallowing in normal populations. Dysphagia 20: 290–296

    Article  Google Scholar 

  • Knigge MA, Thibeault S, McCulloch TM (2014) Implementation of high-resolution manometry in the clinical practice of speech language pathology. Dysphagia 29: 2–16

    Article  Google Scholar 

  • Kocdor P, Siegel ER, Tulunay-Ugur OE (2016) Cricopharyngeal dysfunction: a systematic review comparing outcomes of dilatation, botulinum toxin injection, and myotomy. Laryngoscope 126: 135–141

    Article  CAS  Google Scholar 

  • Kraus E, Rommel N, Stoll L, Oettinger A, Vogel A, Synofzik M (2018) Validation and psychometric properties of the German version of the SWAL-QOL. Dysphagia (in press)

    Google Scholar 

  • Langmore SE (ed) (2001) Endoscopic evaluation and treatment of swallowing disorders. Thieme, New York

    Google Scholar 

  • Langmore SE, Schatz K, Olsen N (1988) Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia 2: 216–219

    Article  CAS  Google Scholar 

  • Leder SB (1996) Gag reflex and dysphagia. Head Neck 18: 138–141

    Article  CAS  Google Scholar 

  • Lindner-Pfleghar B, Neugebauer H, Stösser S, Kassubek J, Ludolph A, Dziewas R, Prosiegel M, Riecker A (2016) Dysphagiemanagement beim akuten Schlaganfall - Eine prospektive Studie zur Überprüfung der geltenden Empfehlungen. Nervenarzt 88: 173–179

    Article  Google Scholar 

  • Lucarelli MR, Shirk MB, Julian MW, Crouser ED (2004) Toxicity of food drug and cosmetic blue No. 1 dye in critically ill patients. Chest 125: 793–795

    Article  Google Scholar 

  • Maloney J, Metheny N (2002) Controversy in using blue dye in enteral tube feeding as a method of detecting pulmonary aspiration. Crit Care Nurse 22: 84–85

    Article  PubMed  Google Scholar 

  • Martin-Harris B, Brodsky MB, Michel Y, Castell DO, Schleicher M, Sandidge J, Maxwell R, Blair J (2008) MBS measurement tool for swallow impairment –MBSImp: establishing a standard. Dysphagia 23: 392–405

    Article  Google Scholar 

  • Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R (2005) Dysphagia after stroke – incidence, diagnosis, and pulmonary complications. Stroke 36: 2756–2763

    Article  Google Scholar 

  • McCullough GH, Wertz RT, Rosenbek JC, Mills RH, Ross KB, Ashford JR (2000) Inter- and intrajudge reliability of a clinical examination of swallowing in adults. Dysphagia 15: 58–67

    Article  CAS  Google Scholar 

  • McHorney CA, Robbins J, Lomax K, Rosenbek JC, Chignell K, Kramer AE, Bricker DE (2002) The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia 17: 97–114

    PubMed  Google Scholar 

  • Mielens JD, Hoffman MR, Ciucci MR, Jiang JJ, McCulloch TM (2011) Automated analysis of pharyngeal pressure data obtained with high-resolution manometry. Dysphagia 26: 3–12

    Article  Google Scholar 

  • Murray J, Langmore SE, Ginsberg S, Dostie A (1996) The significance of accumulated oropharyngeal secretions and swallowing frequency in predicting aspiration. Dysphagia 11: 99–103

    Article  CAS  Google Scholar 

  • Mustafa-Kamal R, Huckabee ML, Kelly BN (2003) Profiling of dysphagia of patients admitted to a stroke ward: a retrospective study. N Z J Speech-Language Ther 58: 4–14

    Google Scholar 

  • Nathadwarawala KM, Nicklin J, Wiles CM (1992) A timed test of swallowing capacity for neurological patients. J Neurol Neurosurg Psychiatry 55: 822–825

    Article  CAS  Google Scholar 

  • Nativ-Zeltzer N, Kahrilas PJ, Logemann JA (2012) Manofluorography in the evaluation of oropharyngeal dysphagia. Dysphagia 27: 151–161

    Article  Google Scholar 

  • Neubauer PD, Rademaker AW, Leder SB (2015) The Yale pharyngeal residue severity rating scale: an anatomically defined and image-based tool. Dysphagia 30: 521–528

    Article  Google Scholar 

  • Olsson R, Nilsson H, Ekberg O (1995) Simultaneous videoradiography and pharyngeal solid state manometry (videomanometry) in 25 nondysphagic volunteers. Dysphagia 10: 36–41

    Article  CAS  Google Scholar 

  • O'Neil KH, Purdy M, Falk J, Gallo L (1999) The dysphagia outcome and severity scale. Dysphagia 14: 139–145

    Article  CAS  Google Scholar 

  • Perry L (2001a) Screening swallowing function of patients with acute stroke. Part one: identification, implementation and initial evaluation of a screening tool for use by nurses. J Clin Nurs 10: 463–473

    Article  CAS  Google Scholar 

  • Perry L (2001b) Screening swallowing function of patients with acute stroke. Part two: detailed evaluation of the tool used by nurses. J Clin Nurs 10: 474–481

    Article  CAS  Google Scholar 

  • Peruzzi WT, Logemann JA, Currie D, Moen SG (2001) Assessment of aspiration in patients with tracheostomies: comparison of the bedside colored dye assessment with videofluoroscopic examination. Respir Care 46: 243–247

    CAS  PubMed  Google Scholar 

  • Pisegna JM, Langmore SE (2016) Parameters of instrumental swallowing evaluations: describing a diagnostic dilemma. Dysphagia 31: 462–472

    Article  Google Scholar 

  • Pluschinski P, Zaretsky Y, Almahameed A, Koseki JC, Leinung M, Girth L, Wagenblast J, Sader R, Stöver T, Hey C (2014) Sekretbeurteilungsskala nach Murray et al. für FEES®: Reliabilitäts- und Validitätsvergleich der deutschen Lang- und Kurzversion. Nervenarzt 85: 1582–1587

    CAS  Google Scholar 

  • Pohl M, Bertram M, Bucka C, Hartwich M, Jöbges, Ketter G, Leineweber B, Mertl-Rötzer M, Nowak DA, Platz T, Rollnik JD, Scheidtmann K, Thomas RS, von Rosen F, Wallesch CW, Woldag H, Peschel P, Mehrholz J (2016) Patientenklientel und Rehabilitationsverlauf in der neurologisch-neurochirurgischen Frührehabilitation – ein Vergleich der Jahre 2002 und 2014. Akt Neurol 43: 534–540

    Article  Google Scholar 

  • Prosiegel M, Heintze M, Wagner-Sonntag E, Hannig C, Wuttge-Hannig A, Yassouridis A (2002) Schluckstörungen bei neurologischen Patienten: Eine prospektive Studie zu Diagnostik, Störungsmustern, Therapie und Outcome. Nervenarzt 73: 364–370

    Article  CAS  Google Scholar 

  • Prosiegel M, Riecker A, Weinert M, Dziewas R, Lindner-Pfleghar B, Stanschus S, Warnecke T (2012) Dysphagie-Management in der akuten Schlaganfallphase. Nervenarzt 83: 1590–1599

    Article  CAS  Google Scholar 

  • Rentsch HP, Bucher PO (2006) ICF in der Rehabilitation: Die praktische Anwendung der internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit im Rehabilitationsalltag. Schulz-Kirchner, Idstein

    Google Scholar 

  • Rosenbek JC., Robbins JA, Roecker EB, Coyle JL, Wood JL (1996) A penetration-aspiration scale. Dysphagia 11: 93–98

    Article  CAS  Google Scholar 

  • Salassa JR, DeVault KR, McConnel FM (1998) Proposed catheter standards for pharyngeal manofluorography (videomanometry). Dysphagia 13: 105–110

    Article  CAS  Google Scholar 

  • Schepp SK, Tirschwell DL, Miller RM, Longstreth WT Jr (2012) Swallowing screens after acute stroke: a systematic review. Stroke 43: 869–871

    Article  Google Scholar 

  • Simons JA, Fietzek UM, Waldmann A, Warnecke T, Schuster T, Ceballos-Baumann AO (2014) Development and validation of a new screening questionnaire for dysphagia in early stages of Parkinson's disease. Parkinsonism Relat Disord 20: 992–998

    Article  Google Scholar 

  • Stanschus S (2002) Videofluoroskopie in der Untersuchung von oropharyngealen Dysphagien: Zur Methode des sprachtherapeutischen Aufgabenteils. In: Stanschus S (Hrsg) Methoden in der klinischen Dysphagiologie. Schulz Kirchner, Idstein

    Google Scholar 

  • Suiter DM, Leder SB (2008) Clinical utility of the 3-ounce water swallow test. Dysphagia 23: 244–250

    Article  Google Scholar 

  • Takahashi N, Kikutani T, Tamura F, Groher M, Kuboki T (2012) Videoendoscopic assessment of swallowing function to predict the future incidence of pneumonia of the elderly. J Oral Rehabil 39: 429–437

    Article  CAS  Google Scholar 

  • Thompson-Henry S, Braddock B (1995) The modified Evan’s blue dye procedure fails to detect aspiration in the tracheostomized patient: five case reports. Dysphagia 10: 172–174

    Article  CAS  Google Scholar 

  • Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A, Brainin M (2007) Dysphagia bedside screening for acute-stroke patients: the Gugging Swallowing Screen. Stroke 38: 2948–2952

    Article  Google Scholar 

  • Trulzsch DV, Penmetsa A, Karim A, Evans DA (1992) Gastrografin-induced aspiration pneumonia: a lethal complication of computed tomography. South Med J 85: 1255–1256

    Article  CAS  Google Scholar 

  • Warnecke T, Dziewas R (2013) Neurogene Dysphagien: Diagnostik und Therapie. Kohlhammer, Stuttgart

    Google Scholar 

  • Zammit-Maempel I, Chapple CL, Leslie P (2007) Radiation dose in videofluoroscopic swallow studies. Dysphagia 22: 13–14

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Von-der-Vringstraβe 9, 81929, München, Deutschland

    Mario Prosiegel

  2. Friedberger Landstraβe 3g, 61197, Florstadt, Deutschland

    Susanne Weber

Authors
  1. Mario Prosiegel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susanne Weber
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Prosiegel, M., Weber, S. (2018). Diagnostik. In: Dysphagie. Praxiswissen Logopädie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56132-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-56132-4_8

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-56131-7

  • Online ISBN: 978-3-662-56132-4

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation