Sky Lakes Medical Center

 

 


    
Health Services - Speech and Language Pathology

Adult Swallowing Disordersalt

In the United States it is estimated that between 6-15 million adults have some form of dysphagia (swallowing difficulties).  This can be the result of a neurological disorder/event (stroke, disease, syndrome, brain injury), head and/or neck cancer, or unknown cause. Dsyphagia can range from minor oral discoordination to severe aspiration (penetration into the lungs) of foods and liquids.  The entire spectrum affects the safety and effectiveness of oral nutrition and hydration.

 

At Sky Lakes Medical Center, the inpatient and outpatient Speech-Language Pathologists provide a broad range of services for Swallowing difficulties (dysphagia). Included are a thorough collection of past history of symptoms and a clinical evaluation of the oral structures, oral and pharyngeal swallowing ability. After the clinical evaluation is completed, recommendations for further instrumental evaluation or strategies, diet modifications, and therapy to increase swallow safety are made.

 

1. Instrumental swallowing evaluations include:

Videofluoroscopic swallow study (VFSS)

A videofluoroscopic swallow study may be ordered after a clinical swallow evaluation is completed if there is concern that a patient may be aspirating on food or liquids, has significant oral dysphagia that can not be seen clearly from the outside, or if patient has significant complaints of food “getting stuck” in the throat.  
This procedure is completed in a radiology suite along with a radiologist and radiology technologist present.  The patient is given different consistencies and textures of food and drink laced with barium to swallow while under fluoroscopy.  The patient’s swallow is evaluated by observing the contrast move through the mouth, throat, and esophagus.

 

Fiberoptic Endoscopic Evaluation of Swallowing and Sensory Testing (FEESST)

A Fiberoptic Endoscopic Evaluation of Swallowing and Sensory Test is a procedure to evaluate a patient swallowing a variety of materials for an extended session.   This test is ordered to evaluate the pharyngeal swallowing abilities.  
The procedure is completed at bedside in the patient’s room at the hospital or for an outpatient, in the speech-language pathology suite.  A flexible endoscope is passed through a patient’s nose to allow viewing of the pharyngeal space.  The patient is then given a variety of liquids and textures to eat and drink so that their swallow may be evaluated for effectiveness and safety.    Recommendations can be made upon this evaluation for further therapy or compensations needed for safe swallowing.

 

2. Swallowing Therapy 

After completing a swallowing evaluation, therapy is often recommended.  Swallowing therapy can include diet modification training, teaching of compensatory strategies, exercises, and neuromuscular electrical stimulation.   
Our newest swallowing therapy provided at Sky Lakes Medical Center in both inpatient and outpatient settings is neuromuscular electrical stimulation, also known as VitalStim.  This is a technique provided by a specially trained and certified therapist in which small electrodes are placed on the neck and face to strengthen and reeducate the muscles that control swallowing.   While the electrodes are in place, exercises and functional swallowing tasks are completed, thus increasing the strength and coordination of the swallowing mechanism.   This FDA approved approach has shown great results with our patients locally and around the country.