The clinician's place for dysphagia awareness, evidence-based practice and information.
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 [...]
Compensatory techniques are used to alter the swallow, however compensations may not create a lasting effect to the swallow. Compensatory strategies may be short term or used more long-term, such as with patients with head and neck cancer. Compensatory strategies can be used to alter posture, timing of the swallow, laryngeal closure. While most compensatory [...]
It's the never-ending soapbox. I know. There was probably even an eye-roll at seeing this article. All. The. Time. Did you get an instrumental? Well, why not? You don't know anything without the instrumental. Reason Numero Uno The number one reason, that I've seen for not obtaining an instrumental is no access. The SLP wants [...]
No matter what you call it...there is a history behind the Modified Barium Swallow Study (MBSS). Gold Standard? The Modified Barium Swallow Study has long been called THE gold standard in dysphagia evaluation, however it does have its limitations. The MBSS definitely continues to be A gold standard in swallowing evaluation. Early Days In the [...]
Why Are You Strangling the Patient? Relax..... You may walk in to observe a Clinical Swallow Evaluation and see an SLP with 3 fingers on a patient's neck as the patient is swallowing. What in the World are they Doing?? It's called laryngeal palpation. The ring finger goes on the patient's cricoid notch, the [...]
What is Cervical Auscultation? Using Cervical Auscultation (CA) involves the use of a stethoscope, placed on the throat to "listen" to the sounds of the swallow. Clinicians often use CA to assess swallow sounds and airway sounds. Judgements are made on the normality of the swallow or the degree of impairment of swallowing. Cervical [...]
I would love to share a story with you. Now keep in mind, I've been an SLP for a lot of years and feel that I do a pretty good job. Sometimes, I may even get a little over-confident in my skills and have to examine what I'm doing. Let's talk about a patient I've [...]
The Clinical Swallowing Evaluation One of the most crucial components, at least for me, of the Clinical Swallow Evaluation (CSE), is the interview. I haven't found a lot of published research regarding the interview portion of the CSE, so if you've found any, please let me know in the comments! There is a nice example [...]
Glossectomy Let's talk total glossectomy for a minute. I've actually worked with multiple partial glossectomies in my career and recently have had 2 total glossectomy patients. It seems like a pretty difficult task, right? Getting someone to eat and drink again with no tongue. Taking the tongue out of the equation of swallowing makes the [...]