[DYSPHAGIA] epiglottic problem?

[dgranof@mail.utexas.edu (Dena Granof)]

I am posting this for a colleague who has asked for help with the 
following case: 48 Y/0 Female complaining of food getting "stuck in 
her throat. Twenty years ago, she was assaulted and sustained some 
neck injuries, she reported some swallowing problems at that time, 
but they had long since resolved. Current problem began about 1 year 
ago. No other significant HX was reported.

The MBS indicated collection of food and liquid in the valleculae--it 
took multiple swallows to clear. Oral phase appeared WNL. A barium 
pill (capsule) got stuck in the valleculae and it took multiple 
swallows with additional liquid to "unstick" the pill. There was 
adequate laryngeal elevation and excursion.

The epiglottis was very "curly" with the tip curling around and 
blocking the vallecular space when at rest. Although there appeared 
to be adequate retroversion, the curly end seemed to  prevent food 
and the pill from coming out of the vallecular space.

Suggestions, comments, where do we go from here, possible cause, etc.

Thank you

Dena H. Granof, Ph.D., CCC-SLP
The University of Texas at Austin
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