Swallowing
Dysphagia is a medical term for difficulty swallowing. This may involve foods, liquids, medications, or even saliva. Speech-language pathologists assess dysphagia which involves the mouth and throat muscles. Speech-language pathologists also assess aspiration risk. Aspiration is a term for entry of food or liquid into the airway. This can lead to aspiration pneumonia. The Hearing and Speech department at WFBH offers comprehensive dysphagia evaluations and treatment programs for rehabilitation.
Evaluation
We offer two comprehensive exams to assess a patient’s difficulty in swallowing. Both of these studies provide information on the swallowing muscles, how foods and liquids are swallowed, and if items are aspirated.
- Fiberoptic Endoscopic Evaluation of Swallowing (FEES) – A small endoscope is gently placed along the floor of the nose to the back of a patient’s throat to visualize the throat from above while swallowing. Various foods and liquids are administered and often dyed with food coloring to allow for greater visualization.
- Pharyngeal Function Study (also known as a Modified Barium Swallow study or videofluoroscopy) – An x-ray study that takes images of the oral cavity and pharynx while swallowing various consistencies of barium or food items mixed with barium. This involves a very low dose of radiation exposure and is performed with a radiologist.
Treatment
Outpatient swallowing treatments in the Hearing and Speech Department at WFBH may include:
- Oral and pharyngeal strengthening exercises – focuses on improving strength, timing, and coordination of the muscles of the mouth, tongue, and throat
- Surface Electromyography (SEMG) – utilizes electrodes that measure muscle contraction
- Lingual manometry – utilizes tongue sensors to measure tongue pressures
- Endoscopic biofeedback – utilizes an endoscope for visual biofeedback
- VitalStim – a therapy modality that delivers an electrical current to a targeted group of muscles. This is performed with traditional swallowing exercises.
These methods provide the patient and the Speech-language pathologist real-time information about the accuracy and intensity of each exercise. This information can be objectively measured, recorded and used for setting goals for future exercises.
We encourage patients to participate in outpatient swallowing therapy 2-3 times per week for 12-16 weeks. We re-evaluate during that time to determine progress and increase goals in therapy. A home program is also essential for progress in therapy. Swallowing therapy takes time and requires commitment, but is essential in improving swallowing function and quality of life.