ASSESSMENT
Options for assessment
The type of assessment required can depend on many factors - nature and duration of the problem, how well someone is, how much they understand, how able they are to move or to sit still, what we're trying to find out, how any findings may influence our future management.
Thorough, appropriate assessment is essential to guide and shape treatment and management. We're much more likely to be able to fix a problem if we understand it properly!
We will identify and recommend the most appropriate assessment based on discussions with you (or others if useful). We will discuss our findings to allow you to make informed decisions and so we can make plans we're all happy with.
Instrumental (or objective) assessments are those where we directly visualise the throat and swallowing and so these assessments provide the most accurate and detailed results.
There are two types - FEES and Videofluorocsopy.
FEES / Nasendoscopy - insertion of a thin tube with a small camera to the back of the nose to allow a view of the throat. We may give you different things to eat and drink during the assessment. This allows detailed assessment of swallowing and/or voice and can identify aspiration (food, fluid or saliva enters the airway) or silent aspiration (food, fluid or saliva enters the airway with no coughing). Laryngeal airway and management of saliva/secretions can also be assessed this way. FEES is a useful assessment for managing tracheostomy. This is a short, painless procedure lasting a few minutes with immediate results. No preparation or recovery is required. Further information is available here.
Videofluorscopy - assessment of swallow function is completed radiologically i.e. via moving x-ray images. You will be given different things to eat and drink while the x-ray machine views you swallowing. We may also try different techniques.Areas of impairments can be identified allowing for accurate diagnosis and suitable management. There is no pain or discomfort during the procedure. Results are available immediately. No preparation or recovery is required. Click here for further information.
FEES and Videofluoroscopy can identify signs or presence of reflux.
Non-instrumental or 'bedside' assessments are when we assess swallowing without directly seeing it. We are likely to feel your throat with our hands and listen with a stethoscope as you swallow.