Swallowing disorders, diagnostics and treatments in South Louisiana region is the subject for today. Some swallowing difficulties can’t be prevented and dysphagia treatment is necessary. A speech-language pathologist will perform a swallowing evaluation to diagnosis your dysphagia. Once the evaluation is completed, the speech pathologist may recommend: diet modification, oropharyngeal swallowing exercises to strengthen muscles, compensatory swallowing strategies, postural modifications that you should follow while eating. However, if swallowing problems are persistent, they can result in malnutrition and dehydration, especially in the very young and in older adults. Recurrent respiratory infections and aspiration pneumonia are also likely. All of these complications are serious and life-threatening and must be treated definitively.

Oral-motor treatments include stimulation to or actions of the lips, jaw, tongue, soft palate, pharynx, larynx, and respiratory muscles that are intended to influence the physiologic underpinnings of the oropharyngeal mechanism in order to improve its functions. Some of these interventions can also incorporate sensory stimulation. Oral-motor treatments range from passive to the more active (e.g., range-of-motion activities, resistance exercises, or chewing and swallowing exercises). Examples of exercises include the following: Laryngeal elevation —similar to the Mendelsohn maneuver (discussed in “Maneuvers” section above), the patient uses laryngeal elevation exercises to lift and maintain the larynx in an elevated position. The patient is asked to slide up a pitch scale and hold a high note for several seconds. This maintains the larynx in an elevated position. Masako or tongue hold —the patient holds the tongue forward between the teeth while swallowing; this is performed without food or liquid in the mouth, to prevent coughing or choking. Although sometimes referred to as the Masako “maneuver,” the Masako (tongue hold) is considered an exercise (not a maneuver), and its intent is to improve movement and strength of the posterior pharyngeal wall during the swallow. Find more details at Swallowing problems.

These diets are all nutritionally adequate. However, some patients may have difficulty taking enough fluid and food to get all the energy and nutrients they need. In this case, an adjustment to diet or treatment will be required. Fluids are essential to maintain body functions. Usually 6 to 8 cups of liquid (48-64 oz) are needed daily. For some dysphagia patients, this may present problems because thin liquid can be more difficult to swallow. In this case, fluid can be thickened to make it easier to swallow. However, close monitoring by the dysphagia team is required for anyone drinking less than 4 cups of thickened fluid a day or anyone not progressing to thin liquids within 4 weeks. The greater problem for some patients is eating enough calories. The whole process of eating simply becomes too difficult and too tiring. However, calorie and protein intake can be increased by fortifying the foods the patient does eat.

Videofluoroscopy (MBSS) has long been viewed as the “gold standard” for evaluation of a swallowing disorder for the comprehensive information it provides. However, it is not very efficient and accessible in certain clinical and practical situations. In addition, MBSS does not allow for the assessment of soft tissue and airway patency, which is an integral component of swallowing function. FEES has been shown to be as equally safe and effective for swallowing evaluation. In fact, research articles have also repeatedly proven that FEES is also a gold-standard assessment and is just as accurate, with even better sensitivity and specificity than MBSS. Read additional info at https://www.dysphagiainmotion.com/.