Updated: Jul 6
Bedside Swallowing Evaluation
A clinical swallowing evaluation is a non-instrumental evaluation of your swallowing function. The clinician will ask a detailed history of your swallowing complaints. Then the clinician will complete an examination of the muscles of your face and throat. You will be given different types of foods and liquids to assess how the muscles of your face and throat are working together to swallow. Recommendations will be discussed with you at the time of the exam, and a report is sent to the referring physician.
Modified Barium Swallow
Modified Barium Swallow (MBS) is a fluoroscopic procedure designed to determine whether food or liquid is entering a person’s lungs, also known as aspiration. It permits the medical team to observe the coordination of anatomical structures in the mouth and throat, as they are actively functioning when chewing, drinking and swallowing. It also identifies the reason for aspiration.
Who is part of the MBS care team?
A speech pathologist administers materials (thin to thick liquid consistencies of Barium and solids as indicated) as the patient is seated upright in the lateral and anterior-posterior positions. A radiologist and radiology technician perform the fluoroscopy (a type of X-ray) to visualize the swallowing process.
What are frequent misconceptions about MBS?
Modified Barium Swallow (MBS) is frequently confused with a Barium Swallow. MBS is an analysis of swallowing through three phases: oral (mouth), pharyngeal (throat) and upper esophagus. A Barium Swallow, on the other hand, focuses on the propulsion of liquid through the esophagus and into the stomach. Differences between these procedures include:
What are the benefits of MBS?
There are many benefits from MBS. It enables the speech pathologist and the physician to identify more clearly the reason or etiology of dysphagia, rule out aspiration and make decisions regarding management of the patient’s swallowing disorder. The speech pathologist needs a specific etiology identified before swallowing treatment can be initiated. A treatment plan is developed for each patient specific to individual needs.
Flexible Endoscopic Evaluation of Swallowing (FEES Exam)
Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is an instrumental examination of swallowing that allows the speech pathologist to view your swallow function as food and liquid pass through your throat and into your esophagus. This is especially helpful if you are experiencing swallowing difficulties such as choking because this is the phase of the swallow where food and liquid pass by the airway.
In order to view the swallow, a small flexible fiberoptic scope is passed through your nose and into your throat, where it is held in position throughout the exam. No anesthetic is required. You are encouraged to bring and eat the foods that you are having difficulty swallowing. The exam is video-recorded and will be reviewed with you immediately. Recommendations will be discussed with you at the time of the exam, and a report is sent to the referring physician.
Swallowing Therapy for Head and Neck Cancer
Treatments for head and neck cancer can cause certain side effects that may affect a patient's speech, eating techniques, swallowing and mouth function. These cancer treatments may include surgery, chemotherapy and radiation, which could present the following side effects:
Dry mouth/throat (xerostomia)
Difficulty swallowing food and/or liquids (dysphagia)
Heavy and sticky mouth secretions
Jaw tightness/pain (trismus)
Loss of appetite
Weight loss and dehydration
Changes in speech/voice
How can a Speech Language Pathologist help patients with head/neck cancer?
Speech Pathologists assist patients during pre and post radiation and surgical treatment and can provide the following:
Instrumental diagnosis of swallowing disorders by Modified Barium Swallow to determine aspiration risk and provide information for specific therapy exercises and compensatory strategies.
Treatment of Dysphagia (difficulty swallowing) utilizing compensatory strategies and specific exercises to improve strength and mobility.
Pre-treatment (before radiation or surgery) with training in swallowing exercises.
Treatment of Dysarthria (speech production) and oral-motor impairments (lip, tongue, jaw movement).
Education and treatment in use of alternative communication devices.