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How do I know if I need an instrumental swallow study?

If you have difficulty swallowing food or liquid, a speech-language pathologist will evaluate your swallow using a variety of consistencies of foods and liquids.  The SLP will check how well you can move the muscles of your mouth and how you swallow. Sometimes the SLP needs more information about how you swallow, using instrumentation.  Instrumentation allows the SLP to gain more information about how the anatomical structures within the larynx (throat) are working so that specific aspects of functioning can be assessed.

What types of instrumentation are there?

There are two types of instrumentation used to assess swallowing.  Fiberoptic endoscopic evaluation of swallowing (FEES) is the first choice method for assessing swallowing disorders.   Some benefits of this method are that it is easy to use, very well tolerated, allows bedside evaluation, and it is cost effective.  During a FEES, a flexible fiberoptic endoscope is introduced through the nose into the patient’s throat area so that he SLP can clearly view the structures of the larynx and pharynx.  Patients are then asked to perform a variety of tasks, including eating and drinking a variety of consistencies.  The most critical finding is aspiration, which is when food or liquid enters the airway instead of the esophagus.

Another type of instrumentation is called Videofluoroscopic Swallowing Study (also known as videofluoroscopy, modified barium swallow, or MBS).  This study is done in a hospital or radiology office.  The patient will sit or stand next to an x-ray machine.  Your SLP will give you different foods or drinks mixed with barium, which makes the food show up on the x-ray.

What are the benefits of FEES?

In addition to the benefits mentioned above, FEES offers the convenience of testing in an office rather than a radiology suite, in approximately 20 minutes with regular food and liquids.  It can be done in the office you normally attend therapy at Long Island Speech and Myofunctional Therapy.  Since there is absolutely no radiation involved, the studies are able to be sustained for longer time intervals, allowing the SLP to see if the patient’s swallowing is affected by fatigue.

Feel free to ask your Speech-Language Pathologist if instrumental testing is right for you!

Nicole Cohen MS CF-SLP