This procedure can be used to observe tongue function and to measure oral transit times, as well as motion of the hyoid bone, but can not visualize the pharynx
Why can ultrasound not image the pharynx?
Because of the mix of tissue types (cartilage, bone, and muscle).
Explain the limited application of ultrasound studies?
Because of the inability to image the pharynx the ultrasound can not visualize the swallow. It is limited to oral tongue function during deglutination and biofeedback for oral tongue exercises.
Which procedure is used to examine the anatomy of the oral cavity and pharynx from above and to examine the pharynx before and after swallowing?
Videoendoscopy is also know as:
Flexible fiberoptic examination of swallowing (FEES)
What part of the swallow does Videoendoscopy not visualize?
The oral stage of the swallow.
How is videoendoscopy performed?
A flexible scope inserted into the nose, down to the level of the soft palate or below.
This procedure can also be performed with a rigid scope placed in the mouth.
Videoendoscopy. The rigid scope usually provides a better image, however the patient can not swallow with the rigid scope in place.
This type of procedure recorded on videotape can provide an excellent superior view of the pharyngeal anatomy, including the relationship between the epiglottis, airway entrance, valleculae, aryepiglottic folds, and pyriform sinuses.
Name a an advantage of Videoendoscopy (FEES)
No radiation exposure
What is the most frequent technique used in the assessment of oropharyngeal swallow?
This procedure allows examination of movement patterns of the bolus and of particular structures in slow motion, frame by frame.
This procedure allows examination of movement patterns of the oral cavity, pharynx, and esophagus during swallowing.
This procedure provides information on bolus transit times, motility problems, and amount and most important etiology of aspiration.
The videofluoroscopy is also alled
Modified Barium Swallow (MBS)
This procedure can used for diagnosing esophageal aspects of swallowing dysfunction.
This procedure is a nuclear medicine test in which the patient swallows measured amounts of a radioactive substances
This procedure can measure the amount of aspiration and residue but can not visualize the physiology of the mouth and pharynx
This procedure has largely been used for research purposes in the oropharynx, rather than a standard clinical tool
This procedure is designed to track vocal fold movement by recording the impedance changes as the vocal folds move toward and away from each other.
This procedure records the sounds produced during the swallow by placing a small microphone on the surface of a patient's neck.
This procedure listens for the "click" associated with the opening of the eustachian tube and the "clunk" associated with the opening of the upper esophageal sphincter.
For this procedure the clinician uses a stethoscope to listen to respiration and define the inhalatory and exhalatory phases of the respiratory cycle. If secretations are in the airway these will be heard (gurgly secretions).
This procedure measures the intrabolus pressures and the timing of the pharyngeal contractile wave.
What procedure would you use if understanding the patient's pharyngeal anatomy is the goal?
What procedure would you use if defining the presence (but not necessarily the cause) of aspiration of saliva is the desired goal?
What procedure would you use if understanding the pharyngeal physiology in relation to symptoms such as aspiration is the issue of interest?
What procedure would you use if the pressure generated during swallowing is the information needed?
Pharyngeal manometry in combination with videofuoroscopy.