Tracking transit time of the bolus through the pharynx and hypopharynx has also allowed useful risk comparisons. A study of patients with acute stroke assessed with MBS showed a strong correlation between prolonged transit—swallows requiring two seconds or more—and readmission with aspiration pneumonia (Arch Phys Med Rehabil.1993;74(9):973-976).
Patients in the intensive care unit or nursing homes, for whom transport to the fluoroscopy suite is not possible, might not be candidates for MBS. It’s also generally avoided in children, for whom exposure to radiation should be minimized.
Keeping Testing In Office
Office-based FEES to assess patients’ oropharyngeal swallow offers portability, avoidance of radiation exposure and real-time visualization of pharyngeal structures. “I find it’s very helpful,” said Robert Stachler, MD, FACS, senior staff physician in the Department of Otolaryngology at Henry Ford Hospital in Detroit. Clinicians can assess patients’ response to positional maneuvers suggested by the speech pathologist and “get automatic feedback on what works and what doesn’t.”