What is Dysphagia?
Dysphagia is the medical term used to describe when patients note difficulty swallowing. Dysphagia can be present in any of the four phases of swallowing: oral preparatory phase, oral phase, pharyngeal phase and the esophageal phase.
Oral Preparatory Phase Dysphagia– can result from paresis (weakness) or paralysis of the lingual (tongue) muscles, muscles used for mastication and sensory receptors in the oral cavity.
Oral Phase Dysphagia– can result from paresis (weakness) or paralysis of the labial lingual, buccal and palatal musculature.
Pharyngeal Phase Dysphagia– can result from reduced or absent movement of the tongue base, epiglottis, hyoid bone, larynx, and upper esophageal sphincter. Any disruption to the sensory and motor neurons that innervate the muscles of the pharynx will also result in pharyngeal dysphagia.
Esophageal Phase Dysphagia– can result from esophageal cancer, esophagitis (inflammation), esophageal stricture and damage to the nervous system.
How is Dysphagia Treated?
Treatment and management for dysphagia is patient specific depending on many factors related to the patients overall medical diagnosis and history. Prior to initiating dysphagia treatment, the SLP begins with an exhaustive review of the patient’s medical records, diagnosis, current prescribed medication list, discussion with the patients primary care provider and finally patient/family interview. Once the SLP has determined the patient is appropriate candidate for dysphagia treatment and management, the SLP begins with a clinical swallow examination. After the clinical swallow examination is completed, the SLP will conduct imaging studies either using FEES or MBSS.
· Clinical Examination- MASA
· Functional Status- FOIS
· Patient Perspective-VAS
· Imaging Studies- FEES/MBSS
· McNeil Dysphagia Therapy Program (MDTP)
· Compensatory Strategies
· Therabite-trismus exercises
· Swallowing maneuvers
· Oral Motor Exercises