Our Services
Evaluation of Swallowing
The functional assessment of swallowing disorders includes one or several procedures that allow the examiners to view the mouth and throat during the process of swallowing. The tests include:
- modified barium swallow (MBS)
This x-ray of swallowing identifies problems that occur in the mouth, at the base of the tongue (back portion of the tongue located in the throat), in the pharynx (throat), larynx (voice box), trachea (wind pipe), lungs, or the esophagus. In addition, this study also provides information about tongue motion and coordination and timing of the swallow. This study is useful not only to identify your problem, but it also offers information that will guide treatment.
- fiberoptic endoscopic evaluation of swallowing (FEES)
The fiberoptic endoscopic evaluation of swallowing is a standard test using a small flexible fiberoptic endoscope, a small tube with a miniature camera and light on the end of it, to view your pharynx (throat) and larynx (voice box). The inside of your nose is coated with an anesthetic gel to reduce the sensation of the endoscope being passed. The endoscope is passed through your nose to a position slightly above the voice box. Once you are comfortable, you will be given foods or liquids that are tinted with food dye so the examiner can follow their passage. The examiner then watches the material as it passes from the base of the tongue into the esophagus (swallowing passageway). Careful observation is made of foods and liquids that are retained in various areas. In addition, careful observation is made of any of the food substances that drip into the airway causing the patient to cough or choke. Important aspects such as the speed of the swallow, the amount of food or liquid that is not swallowed on the first swallow, and amounts of foods or liquids that drop near or into the airway can be observed under clear vision. At the same time, a recording of the entire examination is made so that the treatment team can view the results with you as often as necessary and offer a plan of treatment.
- a FEES test is needed when you complain of a weak voice, you choke after eating or drinking, the food still feels like it is in your throat, or there is a significant change in your voice after swallowing. The entire test takes about five to six minutes once you are properly prepared.
- fiberoptic endoscopic evaluation of swallowing with sensory testing (FEEST)
This study is performed by an otolaryngologist and speech-language pathologist. A puff of air is used to test the protective reflexes of the larynx (voice box) as part of the FEES study.
- manometry
Manometry measures pressures from muscle force (strength) or bolus flow (food moving through the mouth and throat). Manometric pressures are used to measure the strength of swallowing muscles or to determine when swallowing muscles are too tight.
- manofluoroscopy
This is a combination of an MBS and manometry.
- transnasal esophagoscopy (TNE)
The TNE is a procedure in which the inside of the esophagus is examined by a long thin fiberoptic endoscope with a camera on it. The doctor can see the inside of the esophagus by watching a video monitor and determining whether any problems are present.