What to Expect at Your Appointment
Treatment for dysphagia begins with a thorough evaluation to determine the cause of your swallowing problem. This will begin with careful history and routine head and neck examination. This is often followed by endoscopic evaluation of your voicebox and throat, to make sure that there are no lesions there and to observe function.
Additional tests might then include:
- Speech-language pathology clinical swallow evaluation: A speech-language pathologist (SLP) will review your medical history and symptoms, then test the muscles of your face and mouth to evaluate muscle strength and function. The SLP will then ask you to swallow a variety of substances that can include thin liquids, thicker liquids, pureed foods and regular food and observe you for coughing or choking as you swallow.
- Fiberoptic endoscopic evaluation of swallowing (FEES): While this starts the same as a clinical swallow evaluation, it also includes endosopic evaluation of swallowing. A small scope is placed through your nose so the SLP can watch the inside of your throat while you eat and drink.
- Barium swallow study (videofluoroscopic swallow study, cinepharyngoesophagram): This also begins with a clinical swallow evaluation, and then includes x-ray examination of swallowing. You will be asked to swallow a variety of substances mixed with barium so the SLP can see your swallowing as you chew and then swallow. Under close observation, the SLP will look for signs of swallowing dysfunction or aspiration.
The results of the test inform your treatment. Your treatment plan will be individualized to address the particular causes of your dysphagia and what your treatment team may include.
Your care team may include otolaryngologists, laryngologists, gastroenterologists, neurologists and speech-language pathologists. Treatment options may include medication, surgery, dilation of the esophagus, and swallowing exercises to strengthen appropriate muscles, in addition to other things that can be reviewed with you by your otolaryngology and speech language pathology providers.
Dysphagia Treatment After Cancer
Cancer treatments are a common cause of dysphagia. Chemotherapy and radiation treatments can damage the sensitive tissues of the throat. Surgery for cancer can also affect nerves and muscles essential to swallowing.
Our team treats a large number of patients who are undergoing cancer treatment, providing us with a rare degree of skill and expertise in addressing even the most complex swallowing problems
Dysphagia Treatment After Surgery
Surgery to address thyroid, spine, brain, lung or heart disease can cause damage to nerves and muscles important for swallowing. The SLP will work with you to identify these injuries and can help determine whether or not surgical treatments — such as vocal cord injections — may be helpful. If a vocal cord injection is thought to be appropriate for you, our expert otolaryngologists can often perform this as an office procedure and would be happy to review the procedure with you.
If you have undergone nerve grafting surgery to address facial paralysis, our SLPs provide rehabilitation, including testing your lip strength to make sure you are able to create a strong lip seal for safe and healthy swallowing and good speech production.