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Dysphagia pp 411-424 | Cite as

The Therapeutic Swallowing Study

  • Margareta Bülow
  • Bonnie Martin-Harris
Part of the Medical Radiology book series (MEDRAD)

Abstract

Videoradiography is one of the most frequently used instrumental techniques to assess oral and pharyngeal swallowing dysfunction. A therapeutic swallowing study should always be performed in collaboration between a trained speech/language pathologist and a radiologist. Focus during the examination is the oral and pharyngeal phases of deglutition. The swallowing function is tested with various bolus volumes and textures. Implementation of trial therapeutic strategies is another important component of the examination. The study is recorded on a dynamic medium making it possible to analyse structural movements in relation to constant flow after the examination. After the examination the SLP and the radiologist document a collaborative report.

Keywords

Tongue Base Posterior Pharyngeal Wall Bolus Volume Barium Sulphate Dysphagic Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Adnerhill I, Ekberg O, Groher ME (1989) Determining normal bolus size for thin liquids. Dysphagia 4:1PubMedCrossRefGoogle Scholar
  2. Ashford J, McCabe D, Wheeler-Hegland K, Frymark T, Mullen R, Musson N, Schooling T, Hammond CS (2009) Evidence-based systematic review: oropharyngeal dysphagia behavioral treatments: part III—impact of dysphagia treatments on populations with neurological disorders. J Rehabil Res Dev 46(2):195–204PubMedCrossRefGoogle Scholar
  3. Baylow HE, Goldfarb R, Taveira CH, Steinberg RS (2009) Accuracy of clinical judgment of the chin-down posture for dysphagia during the clinical/bedside assessment as corroborated by videofluoroscopy in adults with acute stroke. Dysphagia 24(4):423–433Google Scholar
  4. Bingjie L, Tong Z, Xinting S, Jianmin X, Guijun J (2010) Quantitative videofluoroscopic analysis of penetration-aspiration in post-stroke patients. Neurol India 58(1):42–47PubMedCrossRefGoogle Scholar
  5. Bodén K, Hallgren A, Witt Hedström H (2006) Effects of three swallow maneuvers analyzed by videomanometry. Acta Radiol 47(7):628–633PubMedCrossRefGoogle Scholar
  6. Bülow M, Olsson R, Ekberg O (1999) Videomanometric analysis of supraglottic swallow, effortful swallow and chin tuck in healthy volunteers. Dysphagia 14:67–72PubMedCrossRefGoogle Scholar
  7. Bülow M, Olsson R, Ekberg O (2001) Videomanometric analysis of supraglottic swallow, effortful swallow and chin tuck in patients with pharyngeal dysfunction. Dysphagia 16:190–195PubMedCrossRefGoogle Scholar
  8. Bülow M, Olsson R, Ekberg O (2003) Videoradiographic analysis of how carbonated thin thickened liquids affect the physiology of swallowing in subjects with aspiration on thin liquids. Acta Radiol 44:366–372PubMedGoogle Scholar
  9. Carnaby G, Hankey GJ, Pizzi J (2006) Behavioural intervention for dysphagia in acute stroke: a randomised controlled trial. Lancet Neurol 5:31–37PubMedCrossRefGoogle Scholar
  10. De Pippo KL, Holas MA, Reding MJ (1992) Validation of the 3-ounce water swallow test for aspiration following stroke. Arch Neurol 49:1259–1261CrossRefGoogle Scholar
  11. Denk DM, Bigenzahn W (2005) Management of oropharyngeal dysphagia. Current status. HNO 53(7):661–672PubMedCrossRefGoogle Scholar
  12. Dodds WJ, Logemann JA, Stewart ET (1990a) Radiological assessment of abnormal oral and pharyngeal phases of swallow. AJR Am J Roentgenol 154:965–974PubMedGoogle Scholar
  13. Dodds WJ, Stewart ET, Logemann J (1990b) Physiology and radiology of the normal oral and pharyngeal phases of swallowing. AJR Am J Roentgenol 154:993–1963Google Scholar
  14. Donner M (1988) The evaluation of dysphagia by radiography and other methods of imaging. Dysphagia 1:49–50CrossRefGoogle Scholar
  15. Dziewas R, Warnecke T, Hamacher C, Oelenberg S, Teismann I, Kraemer C, Ritter M, Ringelstein EB, Schaebitz WR (2008) Do nasogastric tubes worsen dysphagia in patients with acute stroke? BMC Neurol 23 8:28CrossRefGoogle Scholar
  16. Ekberg O (1986) Posture of the head and pharyngeal swallow. Acta Radiol Diagn 27:691–696Google Scholar
  17. Ekberg O (1990) The role of radiology in evaluation and treatment of neurologically-impaired patients with dysphagia. J Neurol Rehabil 4:65–73Google Scholar
  18. Ekberg O (1992) Radiologic evaluation of swallowing. In: Groher ME (ed) Dysphagia. Diagnosis and management, 2nd edn. Butterworth-Heineman, Boston, pp 163–195Google Scholar
  19. Ekberg O, Bülow M, Ekman S, Hall G, Stading M, Wendin K (2009) Effect of barium sulphate contrast medium on rheology and sensory texture attributes in a model food. Acta Radiol 50(2):131–138PubMedCrossRefGoogle Scholar
  20. Finestone HM, Foley NC, Woodbury MG, Greene-Finestone L (2001) Quantifying fluid intake in dysphagic stroke patients: a preliminary comparison of oral and nonoral strategies. Arch Phys Med Rehabil 82(12):1744–1746PubMedCrossRefGoogle Scholar
  21. Garcia JM, Chambers E, Molander M (2005) Thickened liquids: practice patterns of speech language pathologists. Am J Speech Lang Pathol 14(1):4–13PubMedCrossRefGoogle Scholar
  22. Gates J, Hartnell GG, Graminga GD (2006) Videofluoroscopy and swallowing studies for neurologic disease: a primer. Radiographics 26(1):e22PubMedCrossRefGoogle Scholar
  23. Groher ME, Crary MA, Carnaby Mann G, Vickers Z, Aguilar C (2006) The impact of rheologically controlled materials on the identifications of airway compromise on the clinical and videofluoroscopic swallowing examinations. Dysphagia 21(4):218–225PubMedCrossRefGoogle Scholar
  24. Heiss CJ, Goldberg L, Dzarnoski M (2010) Registered dieticians and speech-language pathologists: an important partnership in dysphagia management. J Am Diet Assoc 110(9):1290, 1292–1293Google Scholar
  25. Huckabee ML, Steele CM (2006) An analysis of lingual contribution to submental surface electromyographic measures and pharyngeal pressure during effortful swallow. Arch Phys Med Rehabil 87(8):1067–1072PubMedCrossRefGoogle Scholar
  26. Jones B, Donner MW (1989) How I do it: examination of the patient with dysphagia. Dysphagia 4:162–172PubMedCrossRefGoogle Scholar
  27. Kahrilas PJ, Logemann JA, Gibbons P (1992) Food intake by maneuver: an extreme compensation for impaired swallowing. Dysphagia 7:155–159PubMedCrossRefGoogle Scholar
  28. Lazarus CL, Logemann JA, Gibbons P (1993) Effects of manoeuvres on swallowing function in a dysphagic oral cancer patient. Head Neck 15:419–424PubMedCrossRefGoogle Scholar
  29. Lazzara G, Lazarus C, Logemann J (1986) Impact of thermal stimulation on the triggering of the swallow reflex. Dysphagia 1:73–77CrossRefGoogle Scholar
  30. Lim KB, Lee HJ, Lim SS, Choi YI (2009) Neuromuscular electrical and thermal-tactile stimulation for dysphagia caused by stroke: a randomized controlled trial. J Rehabil Med 41(3):174–178PubMedCrossRefGoogle Scholar
  31. Linden P, Sibens A (1983) Dysphagia: predicting laryngeal penetration. Arch Phys Med Rehabil 64:281–283PubMedGoogle Scholar
  32. Logemann JA (1983) Evaluation and treatment of swallowing disorders. Pro-Ed, AustinGoogle Scholar
  33. Logemann JA (1986) A manual for the videofluoroscopic evaluation of swallowing. College-Hill Press, BostonGoogle Scholar
  34. Logemann JA (1995) Dysphagia: evaluation and treatment. Folia Phoniatr Logop 47(3):140–164PubMedCrossRefGoogle Scholar
  35. Logemann J (1998) Evaluation and treatment of swallowing disorders. Pro-Ed, AustinGoogle Scholar
  36. Logemann JA (2008) Treatment of oral and pharyngeal dysphagia. Phys Med Rehabil Clin N Am 19(4):803–816, ixPubMedCrossRefGoogle Scholar
  37. Logemann JA, Kahrilas PJ (1990) Relearning to swallow post CVA: application of maneuvers and indirect biofeedback: a case study. Neurology 40:1136–1138PubMedCrossRefGoogle Scholar
  38. Logemann JA, Kahrilas PJ, Kobara M, Vakil NB (1989) The benefit of head rotation on pharyngoesophageal dysphagia. Arch Phys Med Rehabil 70:767–771PubMedGoogle Scholar
  39. Logemann JA, Lazarus CL, Phillips Keely S, Sanches A, Rademaker AW (2000) Effectiveness of four hours of education in interpretation of radiographic studies. Dysphagia 15:180–183PubMedCrossRefGoogle Scholar
  40. Logemann JA, Rademaker A, Pauloski BR, Antinoja J, Bacon M, Bernstein M, Gaziano J, Grande B, Kelchner L, Kelly A, Klaben B, Lundy D, Newman L, Santa D, Stachowiak L et al (2008) What information do clinicians use in recommending oral versus nonoral feeding in oropharyngeal dysphagia patients? Dysphagia 23(4):378–384Google Scholar
  41. Martin BJW (1994) Treatment of dysphagia in adults. In: Reiff Cherney L (ed) Clinical managements of dysphagia in adults and children. Aspen, Gaithersburg, pp 153–183Google Scholar
  42. Martin BJW, Logemann JA, Shaker R, Dodds WJ (1993) Normal laryngeal valving patterns during three breath-hold manoeuvres: a pilot investigation. Dysphagia 8:11–20PubMedCrossRefGoogle Scholar
  43. Martin-Harris B, Jones B (2008) The videofluorographic swallowing study. Phys Med Rehabil Clin N Am 19:769–785PubMedCrossRefGoogle Scholar
  44. Martin-Harris B, Logemann JA, McMahon S, Schleicher MA, Sandidge J (2000) Clinical utility of the modified barium swallow. Dysphagia 15:136–141PubMedGoogle Scholar
  45. Martin-Harris B, Brodsky MB, Michel Y, Castell DO, Schleicher M, Sandidge J, Maxwell R, Blair J (2008) MBS measurement tool for swallow impairment—MBSImp: establishing a standard. Dysphagia 23:392–405PubMedCrossRefGoogle Scholar
  46. McCabe D, Ashford J, Wheeler-Hegland K, Frymark T, Mullen R, Musson N, Hammond CS, Schooling T (2009) Evidence-based systemtic review: Oropharyngeal dysphagia behavioural treatments. Part IV—impact of dysphagia treatment on individuals’ postcancer treatments. J Rehabil Res Dev 46(2):205–214PubMedCrossRefGoogle Scholar
  47. McCulloch TM, Hoffman MR, Ciucci MR (2010) High-resolution manometry of pharyngeal swallow pressure events associated with head turn and chin tuck. Ann Otol Rhinol Laryngol 119(6):369–376PubMedGoogle Scholar
  48. Murray J (1999) Videofluoroscopic examination. In: Manual of dysphagia assessment in adults. Singular, San Diego, pp 113–151Google Scholar
  49. Nathadwarawala KM, Nicklin J, Wiles CM (1992) A timed test of swallowing capacity for neurological patients. J Neurol Neurosurg Psych 55:822–825CrossRefGoogle Scholar
  50. Nathadwarawala KM, Mc Groary A, Wiles CM (1994) Swallowing in neurological outpatients: use of a timed test. Dysphagia 9:120–129PubMedCrossRefGoogle Scholar
  51. Okada S, Saitoh E, Palmer JB, Matsuo K, Yokoyama M, Shigeta R, Baba M (2007) What is the chin-down posture? A questionnaire survey of speech language pathologists in Japan and in the United States. Dysphagia 22(3):204–209Google Scholar
  52. Pauloski BR (2008) rehabilitation of dysphagia following head and neck cancer. Phys Med Rehabil Clin N Am 19(4):889–928, xPubMedCrossRefGoogle Scholar
  53. Rosenbek JC, Roecker EB, Wood JL, Robbins J (1996) Thermal application reduces the duration of stage transition in dysphagia after stroke. Dysphagia 11:225–233PubMedCrossRefGoogle Scholar
  54. Shaker R, Kern M, Bardan E, Taylor A, Stewart ET, Hoffamnn RG et al (1997) Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise. Am J Physiol 272:G1518–G1522Google Scholar
  55. Shanahan TK, Logemann JA, Rademaker AW, Pauloski BR, Kahrilas PJ (1993) Chin-down posture effect on aspiration in dysphagic patients. Arch Phys Med Rehabil 74:736–739PubMedCrossRefGoogle Scholar
  56. Sonies BC (1993) Remediation challenges in treating dysphagia post head/neck cancer. A problem-oriented approach. Clin Commun Disord 3(4):21–26PubMedGoogle Scholar
  57. Speyer R, Baijens L, Heijnen M, Zwijnenberg I (2010) Effects of therapy in oropharyngeal dysphagia by speech and language therapists: a systematic review. Dysphagia 25(1):40-65.Google Scholar
  58. Splaingard ML, Hutchins B, Sulton LD, Chauhuri G (1988) Aspiration in rehabilitation patients: videofluoroscopy vs bedside clinical assessment. Arch Phys Med Rehabil 69:637–640PubMedGoogle Scholar
  59. Teismann IK, Steinsträter O, Warnecke T, Suntrup S, Ringelstein EB, Pantev C, Dziewas R (2009) Tactile thermal oral stimulation increases the cortical representation of swallowing. BMC Neurosci 10:71PubMedCrossRefGoogle Scholar
  60. Van der Kruis JG, Baijens LW, Speyer R, Zwijnenberg I (2010) Biomechanical analysis of hyoid bone displacement in videofluoroscopy: a systematic review of intervention effects. Dysphagia 26(2):171–182 . doi: 10.1007/s00455-010-9318-9 Google Scholar
  61. Welch MV, Logemann JA, Rademaker AW, Kahrilas PJ (1993) Changes in pharyngeal dimensions effected by chin tuck. Arch Phys Med Rehabil 74:178–181PubMedGoogle Scholar
  62. Wendin K, Ekman S, Bülow M, Ekberg O, Johansson D, Rothenberg E, Stading M (2010) Objective and quantitative definitions of modified food textures based on sensory and rheological methodology. Food Nutr Res 54:5134. doi: 10.3402/fnr.v54i0.5134 Google Scholar
  63. Wheeler-Hegland KM, Rosenbeck JC, Sapienza CM (2008) Submental sEMG and hyoid movement during Mendelsohn maneuver, effortful swallow, and expiratory muscle strength training. J Speech Lang Hear Res 51(5):1072–1087Google Scholar
  64. Witte U, Huckabee ML, Doeltgen SH, Gumbley F, Robb M (2008) The effect of effortful swallow on pharyngeal manometric measurements during saliva and water swallowing in healthy participants. Arch Phys Med Rehabil 89(5):822–828PubMedCrossRefGoogle Scholar
  65. Zammit-Maempel I, Chapple C-L, Leslie P (2007) Radiation dose in videofluoroscopic swallow studies. Dysphagia 22(1):13–15PubMedCrossRefGoogle Scholar
  66. Zenner PM, Losinski DS, Mills RH (1995) Using cervical auscultation in the clinical dysphagia examination in long-term care. Dysphagia 10(1):27–31PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg  2011

Authors and Affiliations

  1. 1.Neurological Department and Diagnostic Centre of Imaging and Functional MedicineSkåne University HospitalMalmöSweden
  2. 2.MUSC Evelyn Trammell Institute for Voice and Swallowing Disorders, Otolaryngology Head and Neck SurgeryMedical University of South CarolinaCharlestonUSA

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