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[Dysphagia] VF anterior view Number 2
I don't think that it would be possible to tell the relative position of the vocal cords if you only did lateral views. Again you can only infer to a certain extent. And I don't only use lateral views. I use lateral, oblique, and, when possible, AP.
-----Original Message-----
From: Irene Campbell-Taylor [mailto:eripley@yahoo.com]
Sent: Friday, November 12, 2004 10:44 PM
To: finger, Janet L; MBrawley@mcw.edu; dysphagia@b9.com
Subject: RE: [Dysphagia] VF anterior view Number 2
I wonder how you can tell the relative position of the vocal cords if you do only lateral views. When I teach the interpretation of VFSS to radiologists, they are always amazed that one can see this and that it is important.
Also, the bilateral function of the epiglottis is impossible to determine without an AP view.
dhealthcare.com wrote:
Exactly. That's why it is optimal to have access to AP view. That's just not always possible for us. So we infer what we can & use clinical judgement. We are luckily to be able to do what we can do with these pts, who are sometimes 500+ lbs &/or on the vent.
-----Original Message-----
From: Brawley, Mary [mailto:MBrawley@mcw.edu]
Sent: Friday, November 12, 2004 3:17 PM
To: finger, Janet L; dysphagia@b9.com
Subject: RE: [Dysphagia] VF anterior view
There's more to asymmetry than just residue. How do you know if there is
bilateral retroversion of the epiglottis or if there is preferential transit
through the pharynx? And how can you assess swallowing strategies/maneuvers?
I am a strong proponent of the A-P view.
-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of Janet.finger@kindredhealthcare.com
Sent: Friday, November 12, 2004 3:49 PM
To: dysphagia@b9.com
Subject: RE: [Dysphagia] VF anterior view
"...if only lateral views are done, it is impossible to tell on which side
something is occurring."
AP view is certainly preferred to answer this question, but it is not
"impossible" to tell on a lateral view. Well, I guess if your view was
PERFECTLY lateral it would be pretty impossible. But most of the time the
view is actually some degree of oblique, which can show asymmetry. I for one
usually can't get my patients to keep their heads stiffly in one position so
that it is a perfectly lateral view throughout a whole study (not that I
try). I often have pts slowly turn their head to each side (not while
swallowing), & can usually get a good idea of asymmetry that way. Can't look
at vocal fold motion that way, though, & it is certainly not the most
optimal way to look for asymmetry I admit. But most of my studies are on pts
who are in bed, using a c-arm (trach/vent facility, lots of bariatrics). We
are not able to get an AP view very easily; fortunately I find I can usually
get all the information I need with lateral & oblique.
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