Paper Title
INNOVATIVE DIAGNOSTICS OF NEUROGENIC DYSPAGIA IN PATIENTS IN ACUTE AND SUBACUTE STAGES OF VASCULAR BRAIN DAMAGE

Abstract
Abstract Introduction Incidence of neurogenic dysphagia in patients after the cerebrovascular accident (CVA) in the form of a strokeis 29 - 81%. The occurrence of dysphagia in the acute period of stroke increases the risk of aspiration pneumonia (AP) 3 times. However, massive neurological deficit coexisting with aspiration increases the risk of AP up to 11 times. In approximately 90% of patients after CVA symptoms of PSD (post stroke dysphagia) withdraw within 2-4 weeks of the onset of CVA. In approximately 8% of patients according to data in Poland, 7-11% in the USA, and even 11-50% according to ESO (European Stroke Organization) PSD persists for 6 months or longer. In Poland 2 instrumental examinations imaging swallowing are the ones “ of choice” : 1/ FEES (Fiberoptic Endoscopic Examination of Swallowing) and 2/ VFSS (Video Fluoroscopic Swallow Study). New diagnostic method of swallowing evaluation using CBCT (Conus Beam Computerized Tomography) proposed by our team complements 2 methods mentioned above. FEES,VFSS and CBCT are the only methods that visualize aspiration to the airways, including the so-called silent aspiration (SA), which isassociated with high risk of AP. Material and method The main aim of the study was to assess the frequency of aspiration of food content into the lower respiratory tract in the group of 81 patients using the FEES study and the CBCT method as an innovative method of assessing swallowing disorders. Among the 81 subjects were: 30 women (37.04%) and 51 men (62.96%). The median age of the subjects was 64.5 years (64.49) and was comparable among men and women (men 64.22 years, women 64.97 years). The FEES and CBCT results were analyzed in terms of: 1. the level of liquid or solid food retention in the lower pharynx 2. the effectiveness of removing food retention from the piriform recesses or lingual-epiglottal fossa 3. the presence of aspirated food content into the trachea. The advantage of the CBCT study proposed by our team in the diagnosis of dysphagia is the ability to assess 3 phases of swallowing in a functional test (in motion) recorded in the form of AVI in the form of 20s. movie. Conclusions In our study, aspiration of food content into the respiratory tract was found in 7.41%of the study group. 1. González-Fernández M, Ottenstein L, Atanelov L, et al. Dysphagiaafterstroke: anoverview. CurrPhysMedRehabil Rep. 2013; 1(3): 187–196, doi: 10.1007/s40141-013-0017-y, indexed in Pubmed: 24977109