The clinician's place for dysphagia awareness, evidence-based practice and information.
Assessment is a critical component of dysphagia management. It is critical to complete an accurate assessment to then create an appropriate therapy plan of care.
It seems that everywhere we go, there are myths that are associated with FEES. There is always that reason that "I just prefer the MBSS." It may be because the MBSS has been performed in your area for much longer than FEES, but there are always other reasons heard on the street. So, here we [...]
Or maybe the question should be, why not FEES? For so long, Modified Barium Swallow Studies (MBSS) have been considered the gold standard. The thing is, FEES has been the red-headed stepchild of swallowing evaluation for quite some time. FEES is gaining traction in the SLP world. So why would you consider FEES? You can [...]
FEES FEES (Flexible Endoscopic Evaluation of Swallowing) is a procedure to assess the swallow. Currently, a laryngoscope is passed transnasally (through the nose) and into the upper pharynx to observe the swallow and the swallow structures through a camera. Picture from: http://www.mc.vanderbilt.edu First Description FEES was first described in the literature in 1988. The [...]
The Modified Barium Swallow Study, no matter what name is used, has been considered a gold standard for many years in the assessment of dysphagia. Recently there has been a lot of debate about whether the MBSS continues to be the gold standard or if FEES (Flexible Endoscopic Evaluation of Swallowing) has taken the place [...]
I was recently directed to a blog post by Clinical Colleagues Confidential. regarding Modified Barium Swallow Studies (MBSS). The title of the blog post is: I have all the answers but nobody is asking me any questions The original blog post can be found at: http://cccslp.net/whats-the-frequency-3/ This is part 2, because I recently wrote a [...]
The Modified Barium Swallow Study The Modified Barium Swallow Study or MBSS is an assessment to determine the physiology of the swallow. The MBSS is often ordered to "determine what consistency is the safest" or to "rule out aspiration" however there is so much more we can discover with the MBSS. The MBSS is [...]
Once upon a time: I worked in a setting and had to send my patients out for the MBSS. Now, I am able to complete my own MBSS and FEES. One thing I take into account when I am doing an MBSS for another SLP is making sure they get a complete study. I have [...]
When completing instrumental assessments, the easiest way to change the swallow is to change the diet consistency. Dr. Jeri Logemann (1993) has suggested using compensatory strategies/maneuvers in the following order: Postural techniques Sensory techniques Maneuvers Diet changes Remember we can often change the swallow through sensory techniques. Steele and Miller 2010 concluded: "Boluses of liquids [...]
So, you know all about MBSS, right? You've learned the MBSImP, you know all about consistencies, all about compensatory strategies. What barium should you use? We are often mixing the same barium used in other studies with food and liquid brought in from the kitchen. At one point, there was a recipe available to make [...]
A Moment in Time Most people call the Modified Barium Swallow Study (MBSS) a "snapshot in time" or a "moment in time". You can't possibly trial every single consistency the person may eat while under fluoro. The radiation exposure would get to be ridiculous and the kitchen in your facility may not like you much [...]