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What is dysphagia?

Dysphagia is the medical term for “difficulty swallowing.” The following symptoms may indicate that you or a loved one may benefit from an evaluation:

  • Difficulty initiating a swallow

  • Coughing or choking during meals

  • Pain or discomfort while swallowing

  • Feeling something “stuck” in the throat

  • Feeling food or liquid “coming back up” after meals

  • Difficulty swallowing pills

  • Sudden decrease in appetite

  • Repeated diagnoses of pneumonia

  • Shortness of breath during or after meals

Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

A clinical bedside evaluation cannot accurately detect or diagnose dysphagia. Imaging is required for an accurate diagnosis and prognosis. FEES is a cost-effective and convenient alternative to modified barium swallowing studies (MBSS) that are typically performed in hospitals. An endoscopic evaluation provides the imaging necessary to diagnose dysphagia, and develop patient-centered treatment plans to improve outcomes. No radiation exposure is required and no barium is used during the examination.

What are voice disorders?

Voice disorders occur when pitch, loudness, or quality of voice differ than what is typically expected, and may impact a patient’s ability to complete daily tasks. These difficulties can be attributed to many different causes including: phonotrauma (e..g, yelling, chronic cough, excessive throat clearing), muscle tension dysphonia, vocal nodules, polyps, inflammation, Parkinson’s disease, Multiple Sclerosis, and many others.

If you or a loved one’s voice sounds “different” that normal, a formal voice evaluation may be indicated. Changes in the voice may include the following:

  • roughness,

  • breathiness,

  • hoarseness,

  • strangled quality,

  • abnormal pitch/loudness,

  • gurgley/wet voice,

  • aphonia (loss of voice),

  • phonation breaks,

  • “weak” voice,

  • increased vocal effort,

  • variable vocal quality throughout the day,

  • excessive throat tension

Rigid Stroboscopy

Completing a stroboscopic evaluation of the voice allows the speech-language pathologist to view the function of the vocal folds in great detail. Results from this exam allow for a patient-centered treatment plan to improve vocal function to as close to “normal” as possible.

Perceptual, Aerodynamic, and Acoustic Voice Evaluations

A perceptual evaluation is completed using standardized and informal measures such as: Voice Handicap Index (VHI), Consensus Auditory Perceptual Evaluation of Voice (CAPE-V), and Reflux Symptom Index (RSI).

Aerodynamic assessments are completed using a spirometer. Vital capacity is determined as well as maximum phonation time (MPT), phonation quotient, and estimated mean flow rate.

An acoustic evaluation is completed using software to record sound provided by the patient such as saying “ah” for as long as possible, reading, and/or having general conversation. The sound is then recorded and analyzed for pitch, loudness, fundamental frequency, and Cepstral peak.