Nasofibroscopía De La Deglución:Propuesta de Protocolo Cooperativo en Fonoaudiología y Otorrrinolaringología

Nasofibroscopy Of Swallowing:Proposal for a Cooperative Protocol In Speech Therapy and Otorrhinolaryngology. Propuesta De Protocolo Cooperativo En Fonoaudiología Y Otorrrinolaringología.

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Belkis David Parra Reyes
Hellen Angulo Luna
Resumen

El objetivo es presentar la metodología de nuestro protocolo de evaluación nasofibroscópica de la deglución de manera cooperativa y difundir entre los otorrinolaringólogos y fonoaudiólogos que es un proceso ágil, sencillo y fácilmente factible de estudiar, diagnosticar y planear la terapia de las disfagias orofaríngeas de manera conjunta en el equipo multidisciplinar. Fue un estudio piloto descriptivo transversal donde se aplicó la nasofibroscopía de la deglución mediante el protocolo de evaluación funcional como método multidisciplinario cooperativo, tomando una muestra piloto de 29 adultos, con una edad promedio de 62.5 años. Se realizó en pacientes sin ninguna alteración en el estado de conciencia y que presenten hallazgos compatibles con disfagia en el contexto de patología neurológica, post intubación y algunos pacientes disfónicos. El protocolo se inicia con la anamnesis, examen físico y funcional de las estructuras orofaciales, y finaliza con el examen endoscópico clínico de las estructuras implicadas en la disfagia orofaríngea. Después de la aplicación de la prueba piloto, se observó los sucesos durante el proceso de deglución. Los hallazgos frecuentes fueron: presencia de residuos en los valléculas y recesos faríngeos tras ingestión de consistencia tipo pudín, además de escape posterior de líquidos en consistencia tipo néctar. Se concluye que la nasofibrosopia de la deglución es un examen objetivo muy versátil, fácil y seguro de realizar, que permite realizar un diagnóstico adecuado de la disfagia orofaríngea, que si se aplica de la manera cooperativa entre el fonoaudiólogo y el otorrinolaringólogo puede orientar el trabajo de rehabilitación y la conducta terapéutica.

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Hellen Angulo Luna, Hospital Nacional Hipólito Unanue MINSA, Lima, Perú

Otorrinolaringóloga del Centro de Motricidad Orofacial, Lima, Perú. Departamento de Otorrinolaringología, Hospital Nacional Hipólito Unanue, MINSA, Lima, Perú 

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