ASSESSMENT...

1. Bedside swallowing examination

2. Instrumental assessment
 1. Bedside swallowing examination
 Medical record review
 History taking

◦ Identify chief complaint, associated symptoms, family

hx, and so on.
 Oromotor examination

◦ Include an assessment of lip closure, tongue strength

and mobility, facial symmetry
 Meal observation

◦ Observe food/liquid intake for amount, consistency

and timing of the meal to achieve max. nutrition with
min. swallowing difficulty.
 2. Instrumental assessment
 Videofluroscopic Swallowing Study (VFSS)
◦ Also called Modified Barium Swallow (MBS)
◦ A dynamic radiography imaging of anatomy
& physiology of swallowing-recorded on a
standard video recorder
◦ View oral, pharyngeal, laryngeal &
esophageal part laterally or
anteroposteriorly
 Fiberoptic Endoscopic Examination of
Swallowing (FEES)
◦ View larynx & pharynx superiorly
 Others

◦ Electromyography (EMG)
◦ Electroglottography (EGG)
◦ Manometry
◦ Ultrasound
◦ Oxygen Saturation
 MANAGEMENT...
a) Enteral feeding
b) Nonsurgical treatment
c) Surgical treatment
 a) Enteral feeding
 Nasogastric
◦ This is the most commonly used
delivery route.
◦ Passes through the nose, pharynx,
and lower esophageal sphincter and
into stomach
 Gastrotomy
◦ placement of a feeding tube through
the skin and the stomach wall, directly
into the stomach.
 Jejunostomy
◦ It is inserted through the skin, and
then runs either directly into the
jejunum or into the stomach and then
into the jejunum.
 b) Nonsurgical treatment
 Compensatory
◦ Oral sensory awareness
◦ Postural techniques
 Theraphy

◦ Oral & pharyngeal exercises

◦ Diet modification
◦ Swallow maneuvers
 Prosthetic

◦ Dentition
◦ Lingual prothesis
 c) Surgical treatment
 Cricopharyngeal myotomy

 Laryngectomy
CONCLUSION..
 As we age, the neuromuscular system and
body reflexes needed for swallowing tend to
become slower.
 To keep your swallow flexible and normal as

you age, it is recommended that you do each

of aerobic exercises 2-3 times a day.