Evaluation of oropharyngeal dysphagia through nasofibrolaryngoscopy using the HYODO scale as predictive value to reform gastrostomy

Abstract

Oropharyngeal dysphagia is a frequent pathological condition, especially in older adult patients. It is associated with a number of diseases (mainly neurological and traumatic), and carries a considerable risk of aspiration and pneumonia. Nasofibroscopic evaluation of swallowing is a technique that allows studying the physiology of swallowing, estimating the risk of aspiration, providing guidance on the safest way to feed the patient and the need for gastrostomy. The objective is to describe the nasofibroendoscopic findings in oropharyngeal dysphagia and categorize the severity by the Hyodo scale as a predictive value for gastrostomy. 42 patients were evaluated by performing nasofibrolaryngotomy endoscopy where the degree of dysfunction was assessed according to the Hyodo scale to establish dietary measurements and gastrostomy requirement.The results show a prevalence of the male sex of 28 cases (66.7%), over the female of 14 cases (33.3%). The underlying diagnoses corresponded mostly to neurological pathology, with 23 cases (54.8%), followed by recurrent pneumonia in 9 cases and head trauma (TBI). In the Hyodo scale, 23 patients (64.2%) scored equal to or less than 7 points and nineteen patients, representing 35.8%, classified as having severe dysfunction, that is, with a score equal to or greater than 8, which led to gastrostomy in 31% of patients. Nasofibrolaryngoscopy associated with the Hyodo scale is useful to assess patients with clinical suspicion of aspiration and swallowing disorders; It allows establishing therapeutic and complementary strategies to modify diet, swallowing therapies and the need for gastrostomy.