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[DYSPHAGIA] epiglottic problem?



At 11:00 AM 11/6/01 -0600, you wrote:
>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.

With no other medical problems, epiglottis does invert, etc. I guess I
would want to explore other medical issues such as menopause causing
increased mucousal dryness that may make pills/food stick. She is the right
age to have menopause be a complicating factor. The curly epiglottis can
cause more problems in the older pt population who take drugs that cause
mucousal dryness and/or have reduced oral transit/strength of bolus propulsion.

That's my 2 cents worth.

Sara M Hoffman, MS, CCC-SLP

>
>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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