Videofluoroscopic examination – study procedure with an assessment questionnaire

In this article, we proposed a questionnaire for assessment of videofluorscopic examination in patients with swallowing disorders. It was developed during years 2015 - 2016 by the Department of Otolaryngology at the Medical University of Warsaw. The main body of the form consists of 3 parts assessing the oral phase, the pharyngeal phase and the esophageal phase. The main column contains a list of specific symptoms with yes/no answers. There is a four-point scale assessing the severity of the disorders from 0 to 3, where 0 corresponds to clinically insignificant findings, 1- mild impairment, 2 - moderate impairment, and 3 – severe impairment. Other elements of the form include: basic demographic and nutritional data, assessment of the consistency and texture of ingested food, food texture recommended based on the evaluation acc. to the recommendations of the International Dysphagia Diet Standardization Initiative (www.iddsi.org), and therapeutic assessment before implementation of speech therapy. The questionnaire was prepared on the basis of Trinity College survey, own experience and literature data.