|
[Date Prev][Date Next]
[Chronological]
[Thread]
[Top]
[Dysphagia] VF anterior view
You just very clearly stated my "logic." Thank you.
-----Original Message-----
From: Irene Campbell-Taylor [mailto:eripley@yahoo.com]
Sent: Wednesday, November 17, 2004 8:16 PM
To: finger, Janet L; dysphagia@b9.com
Subject: RE: [Dysphagia] VF anterior view
Janet.finger@kindredhealthcare.com wrote:
Most of the time instrumental exam isn't needed anyway, so I'm not about to give up on these folks just because I can't do AP.
*** I'm sorry but I don't follow the logic. If they aren't needed why do them and why not rely on a full clinical exam that gives at least as much information - and, more importantly, can provide the cause of the problem - the essential information without which no treatment can be valid. VFSS will identify abnormal dynamics but won't necessarily provide information leading to the cause of the dysphagia/abnormalities. For example, on a lateral view one will most often see poor hyoid movement. This can be identified clinically .In both cases, in depth study of the history as well as complete clinical examination are essential for management.
If located in one of the many, many places where VFSS isn't available, the clinical exam combined with full history is sufficient.
-----Original Message-----
From: Irene Campbell-Taylor [mailto:eripley@yahoo.com]
Sent: Friday, November 12, 2004 10:25 PM
To: finger, Janet L; MBrawley@mcw.edu; dysphagia@b9.com
Subject: RE: [Dysphagia] VF anterior view
Janet.finger@kindredhealthcare.com wrote:
. We are luckily to be able to do what we can do with these pts, who are sometimes 500+ lbs &/or on the vent.
*****Why are you attempting anything with such patients via VFSS? It's pointless. You should be able to identify what you need to know clinically.
-----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.
*************************************************************
The information contained in this E-mail transmission is
intended only for the use of the individual or entity to whom
it is addressed. It may contain privileged, confidential,
and protected health information.
If you received it in error, you are on notice of its status.
Please notify us immediately by reply e-mail and then please
delete this message from your system. Please do not copy it
or use it for any purposes, or disclose its contents to any
other person. To do so could violate state and Federal
privacy laws. Thank you for your cooperation.
Please contact the sender if you need assistance.
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
*************************************************************
The information contained in this E-mail transmission is
intended only for the use of the individual or entity to whom
it is addressed. It may contain privileged, confidential,
and protected health information.
If you received it in error, you are on notice of its status.
Please notify us immediately by reply e-mail and then please
delete this message from your system. Please do not copy it
or use it for any purposes, or disclose its contents to any
other person. To do so could violate state and Federal
privacy laws. Thank you for your cooperation.
Please contact the sender if you need assistance.
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
*************************************************************
The information contained in this E-mail transmission is
intended only for the use of the individual or entity to whom
it is addressed. It may contain privileged, confidential,
and protected health information.
If you received it in error, you are on notice of its status.
Please notify us immediately by reply e-mail and then please
delete this message from your system. Please do not copy it
or use it for any purposes, or disclose its contents to any
other person. To do so could violate state and Federal
privacy laws. Thank you for your cooperation.
Please contact the sender if you need assistance._______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
*************************************************************
The information contained in this E-mail transmission is
intended only for the use of the individual or entity to whom
it is addressed. It may contain privileged, confidential,
and protected health information.
If you received it in error, you are on notice of its status.
Please notify us immediately by reply e-mail and then please
delete this message from your system. Please do not copy it
or use it for any purposes, or disclose its contents to any
other person. To do so could violate state and Federal
privacy laws. Thank you for your cooperation.
Please contact the sender if you need assistance.
|
|