Instrumental Evaluation of Swallowing Flashcards
1
Q
Discuss Videoendoscopy. What does it examine?
A
Videoendoscopy/ FEES:
Examines:
- anatomy of oral cavity & pharynx
- pharynx & larynx before & after swallowing (not during)
- Flexible endoscope is used for viewing
- Light topical anesthetic is sprayed in the nose
- If you numb the throat, you could miss functions that are typicall present
Oral phase examination? Yes, because you can watch from the mouth.
VP mechanism examination? Yes, you can see the closure.
- inward movt of lateral pharyngeal walls, post pharyngeal walls
- elevation and retraction of the soft palate.
Closed period / White out happens during the swallow
2
Q
What are the shortcommings of a videoendoscopy?
A
Shortcomings of FEES:
- Difficulties viewing motor activity during swallowing
- Difficulty determining effects of treatment strategies
- Can infer from location of residue after swallow
- Cooperation in children below 6-8 years is a challenge
- Cognitive disorders –> agitation –> challenge
3
Q
What are the pros of using a FEES?
A
- Excellent superior view of pharynx
- No radiation exposure
- Sensory awareness testing using the tube
- Used to provide biofeedback for airway closure maneuvers
- Patient can view structures when performing maneuvers
4
Q
Discuss Videofluoroscopy.
A
Videofluoroscopy/MBSS/VFSS/ Pharyngogram:
- Most commonly used
- Exist since 1900s
- Current: Videotape, DVD
- Radiation exposure in cinefluoroscopy> VFSS
5
Q
What are the pros of an MBS? What does it measure?
A
Videofluoroscopy/MBSS/VFSS:
- Slow motion in VFSS helps detect movement disorders best
- No special equipment is needed
- VFS studies provide information on:
- bolus transit times
- motility problems
- amount of aspiration
- etiology of aspiration
- chewing
- oral stage of swallow
- pharyngeal swallow trigger
- swallow trigger wrt bolus position
- motor aspects of pharyngeal swallow
- movt of hyoid and larynx
- movt of tongue base and phgeal walls
- CP region
