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[Dysphagia] audible swallow
Anterior Cervical Disc Fusion--sorry.
----- Original Message -----
From: "SLP" <slpinor@isp.com>
To: "Theresa Szmansky" <tszmansky@pobox.com>
Sent: Thursday, September 01, 2005 4:05 PM
Subject: Re: [Dysphagia] audible swallow
> Can you please clarify what teh ACDF means? thanks!
>
> Theresa Szmansky wrote:
>
>> I am currently seeing 2 patients with this characteristic.
>>
>> 1. Tonsillar cancer; s/p right rad neck dissection with chemo and
>> radiation. Had a very audible swallow (dare I use the word 'squishy' to
>> describe it) with a heavier pureed consistency (i.e. tapioca)--unable to
>> clear and required expectoration of the bolus. I happened to have a
>> repeat MBSS scheduled since I am doing vital stim with him, so I was able
>> to get a visual. He had a significant increase in post-swallow residue
>> in the pyriforms with this consistency and because of the cricopharyngeal
>> dysfunction the residue scattered all around the posterior pharyngeal
>> wall and the laryngeal vestibule. I recommended dilatation, which he
>> just had done this week and treatment was resumed. He ate a whole
>> container of tapioca during treatment and that audible (squishy) swallow
>> was eliminated. The gastro doc said he could not believe any food/liquid
>> passed into the esophagus (but, it did when is was smooth and
>> thinner--the more his pharyngeal strength improved, the more the bolus
>> passed to the esophagus, so this problem was not identified until this
>> point in tx). Next dilatation is in 2 weeks.
>>
>> 2. Second pt is an ACDF (C4-7) with a plate, who had pharyngeal
>> dysphagia due to edema. Now edema is resolving, but the pt is left with
>> an audible ('clicking') swallow only with thin liquids
>> (inconsistent--about 75% of the time). No clinical s/s of aspiration
>> noted and clear vocal quality.
>>
>> This discussion has been very helpful and insightful in regards to these
>> patient. I only saw a MBSS on the first pt, but I felt that clinically
>> they both appeared safe in terms of airway protection. Thank
>> you..........would love to hear more insight regarding this
>> characteristic in the ACDF population if it is out there.
>>
>>
>> ----- Original Message ----- From: "Houts, Karen L"
>> <KHouts@stanfordmed.org>
>> To: <dysphagia@b9.com>
>> Sent: Thursday, September 01, 2005 1:23 PM
>> Subject: RE: [Dysphagia] audible swallow
>>
>>
>> I have seen some pts that have a audible galuping sort of sound, for lack
>> of a better way to describe it. On the VFS the bolus was poorly
>> controlled. The valleculae & especially the pyriforms were well filled
>> before the swallow. This galuping sound was consistently timed with the
>> retropulsion of the material in the pharynx as the swallow was initiated
>> & the structures began to rise. I dont know if what we heard was the
>> actual motion of the material or the air being pushed thru the material
>> as the area is compressed. However each of these people had good airway
>> protection so it wasnt that important. I just consider the sound a bit of
>> a red flag that may or may not require any intervention depending on the
>> rest of the picture.
>>
>>
>> Karen Houts OTR/L-SWC
>>
>> -----Original Message----- From: dysphagia-bounces@b9.com on behalf of M.
>> Tervo
>> Sent: Tue 8/30/2005 5:19 PM
>> To: dysphagia@b9.com
>> Cc:
>> Subject: [Dysphagia] audible swallow
>>
>>
>>
>> I heard at a conference that a audible swallow is a disordered swallow.
>> I have been unable to locate any info that explains the details of
>> this...can anyone please explain this further?
>>
>>
>>
>>
>> ---------------------------------
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