Swallow therapy includes conducting a thorough evaluation and making an individualized rehabilitation plan. We use state-of-the art tools for swallowing analyses including Video Fluoroscopic Swallow Study (VFSS) and Fiber-Optic Endoscopic Evaluation of Swallowing (FEES). Rehabilitation plans usually include finding new approaches based on your specific challenges or exercises to stretch and strengthen the muscles used for swallowing.
Videofluoroscopic Swallow Study (VFSS)
Your Speech Language Pathologist (SLP) uses this procedure as a baseline measurement for your swallowing prior to starting your cancer treatment. It’s also used about 3 to 4 weeks after treatment, and yearly for maintenance. It provides a direct, dynamic view of your oral, pharyngeal (throat), and upper esophageal (the tube that runs from your throat to your stomach) function during swallowing.
This procedure uses food and liquids mixed with Barium to assess your oral preparatory (when food is chewed and mixed with saliva to form a soft consistency), oral transit (when food is moved back through the mouth with a front-to-back squeezing action), pharyngeal, and/or esophageal phases of swallowing. It will also help determine treatment and management strategies to minimize the risk of sucking food into your airway and increasing swallowing efficiency.
Radiation safety is important for everyone in the room throughout this procedure. Acceptable levels of radiation exposure are controlled by the radiologist and radiology department.
Fiber-Optic Endoscopic Evaluation (FEES) Procedure
This procedure takes about 15 to 20 minutes and assesses how well you swallow. Preparing for this includes following any special diet you’ve been placed on prior to your visit. Please arrive about 15 minutes before your scheduled appointment. The FEES procedure takes place on the first floor of Community Cancer Institute in the Radiation department.
There are two basic parts to this exam. Part one views the way you swallow and manage your own saliva, and part two views the way you swallow different textures of foods and liquids. The FEES procedure uses a thin, flexible instrument called an endoscope. During the procedure you’ll be seated and awake. Your SLP lubricates the endoscope with jelly so it comfortably passes through your nose and down your throat. You may feel some discomfort.
The endoscope lets your Speech Language Pathologist (SLP) see parts of your Larynx (voice box), Pharynx (throat), and Trachea (windpipe) on a video screen as you swallow. Once the endoscope is in the correct position, your SLP will have you complete a few verbal tasks and movements.
Next, food and liquid will be introduced. Food coloring is used to contrast the food and liquids from the rest of your throat. Your SLP may also ask you to try different positions or textures to fully evaluate your throat and swallowing function. This procedure can also be used as a therapy to provide feedback to you while you try to eat different foods.
Once the procedure is complete, the scope will be quickly removed. Risks of this procedure include nosebleed,
brief closure of airway, and aspiration (usually only a small amount). Your SLP will work to minimize these risks.
After your procedure, your SLP will review the results with you and place you on an appropriate diet.