M K Almardini, M Alshipli, P Maniam, H Mohd Ibrahim
{"title":"A systematic review of water-soluble contrast use in videofluoroscopic examination of dysphagia.","authors":"M K Almardini, M Alshipli, P Maniam, H Mohd Ibrahim","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The Videofluoroscopic Swallow Study (VFSS) is a key diagnostic tool for evaluating swallowing function, providing dynamic visualization of bolus transit and swallowing mechanism. Traditionally, barium is used as the contrast medium due to its effectiveness in highlighting anatomical and functional aspects of swallowing. However, water-soluble contrast (WSC) agents, which differ in osmolarity, viscosity, and iodine atom-particle ratio, have emerged as alternatives and their optimal use in VFSS remains unclear. This systematic review investigates the utilization of WSC agents in VFSS.</p><p><strong>Materials and methods: </strong>This systematic review was conducted following the PRISMA 2020 guidelines, extensively analyzing WSC agents use in VFSS. Searches were conducted across PubMed, Scopus, and Google Scholar using keywords \"Water-Soluble Contrast, Videofluoroscopic, High-Osmolar Water-Soluble Contrast, and/or Low-Osmolar Water-Soluble Contrast\". A total of 574 papers were initially identified.</p><p><strong>Results: </strong>Nine studies (2013-2021) investigated the use of WSC agents in VFSS. The studies varied in methodology and WSC agents used, with no standardized protocols identified. Findings indicated that low-osmolar WSCs may reduce the risk of complications, such as aspiration and pulmonary edema, compared to barium sulfate. WSC agents were utilized in high-risk populations, such as those with head and neck surgeries or neurological conditions.</p><p><strong>Conclusion: </strong>WSC agents may serve as a viable alternative to barium sulfate in VFSS, particularly for high-risk patients. However, further research is needed to compare their diagnostic accuracy, patient outcomes, and safety profiles, as well as to establish standardized protocols for their use in dysphagia evaluation.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"500-507"},"PeriodicalIF":0.0000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Malaysia","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: The Videofluoroscopic Swallow Study (VFSS) is a key diagnostic tool for evaluating swallowing function, providing dynamic visualization of bolus transit and swallowing mechanism. Traditionally, barium is used as the contrast medium due to its effectiveness in highlighting anatomical and functional aspects of swallowing. However, water-soluble contrast (WSC) agents, which differ in osmolarity, viscosity, and iodine atom-particle ratio, have emerged as alternatives and their optimal use in VFSS remains unclear. This systematic review investigates the utilization of WSC agents in VFSS.
Materials and methods: This systematic review was conducted following the PRISMA 2020 guidelines, extensively analyzing WSC agents use in VFSS. Searches were conducted across PubMed, Scopus, and Google Scholar using keywords "Water-Soluble Contrast, Videofluoroscopic, High-Osmolar Water-Soluble Contrast, and/or Low-Osmolar Water-Soluble Contrast". A total of 574 papers were initially identified.
Results: Nine studies (2013-2021) investigated the use of WSC agents in VFSS. The studies varied in methodology and WSC agents used, with no standardized protocols identified. Findings indicated that low-osmolar WSCs may reduce the risk of complications, such as aspiration and pulmonary edema, compared to barium sulfate. WSC agents were utilized in high-risk populations, such as those with head and neck surgeries or neurological conditions.
Conclusion: WSC agents may serve as a viable alternative to barium sulfate in VFSS, particularly for high-risk patients. However, further research is needed to compare their diagnostic accuracy, patient outcomes, and safety profiles, as well as to establish standardized protocols for their use in dysphagia evaluation.
期刊介绍：
Published since 1890 this journal originated as the Journal of the Straits Medical Association. With the formation of the Malaysian Medical Association (MMA), the Journal became the official organ, supervised by an editorial board. Some of the early Hon. Editors were Mr. H.M. McGladdery (1960 - 1964), Dr. A.A. Sandosham (1965 - 1977), Prof. Paul C.Y. Chen (1977 - 1987). It is a scientific journal, published quarterly and can be found in medical libraries in many parts of the world. The Journal also enjoys the status of being listed in the Index Medicus, the internationally accepted reference index of medical journals. The editorial columns often reflect the Association''s views and attitudes towards medical problems in the country. The MJM aims to be a peer reviewed scientific journal of the highest quality. We want to ensure that whatever data is published is true and any opinion expressed important to medical science. We believe being Malaysian is our unique niche; our priority will be for scientific knowledge about diseases found in Malaysia and for the practice of medicine in Malaysia. The MJM will archive knowledge about the changing pattern of human diseases and our endeavours to overcome them. It will also document how medicine develops as a profession in the nation. We will communicate and co-operate with other scientific journals in Malaysia. We seek articles that are of educational value to doctors. We will consider all unsolicited articles submitted to the journal and will commission distinguished Malaysians to write relevant review articles. We want to help doctors make better decisions and be good at judging the value of scientific data. We want to help doctors write better, to be articulate and precise.
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