92610 Evaluation of oral and pharyngeal swallowing function

Name of the Procedure:

Evaluation of Oral and Pharyngeal Swallowing Function (also known as a Swallow Study, Videofluoroscopic Swallowing Study, or Modified Barium Swallow Study)

Summary

The Evaluation of Oral and Pharyngeal Swallowing Function is a diagnostic procedure that helps assess how well a person can swallow. This study usually involves using X-rays to observe the swallowing process in real-time, ensuring everything is functioning properly and identifying any issues.

Purpose

• Medical Condition: This procedure addresses difficulties in swallowing (dysphagia).
• Goals: To identify the cause of swallowing problems, ensuring food and liquid are going down the right way, and to develop a treatment plan to improve or manage swallowing function.

Indications

• Patients experiencing symptoms like coughing or choking when eating or drinking.
• Patients with conditions that affect swallowing, such as strokes, neurological diseases, head or neck cancer, or surgery.
• Frequent respiratory infections potentially due to aspiration (food or liquid entering the airway).

Preparation

• The patient might need to fast for a few hours prior to the study.
• Remove any jewelry or dentures before the procedure.
• Provide a detailed medical history, especially concerning previous swallowing issues or related medical conditions.

Procedure Description

1. The patient will be seated upright, usually in front of an X-ray machine.
2. Different food and liquid textures mixed with barium (a contrast material) are given to the patient to swallow.
3. As the patient swallows, X-rays capture real-time images of the oral and pharyngeal phases of swallowing.
4. The procedure is usually monitored by a speech-language pathologist along with a radiologist.
5. The images are analyzed to observe the movement of food and liquid through the mouth, throat, and into the esophagus, checking for any abnormalities or aspiration.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

Performed in a hospital radiology department or an outpatient clinic equipped with the necessary imaging technology.

Personnel

• Speech-language pathologist
• Radiologist
• Radiologic technologist

Risks and Complications

• Minimal exposure to radiation.
• Potential for discomfort or difficulty swallowing barium.
• Rarely, patients might experience constipation after ingesting barium.

Benefits

• Helps accurately diagnose swallowing disorders.
• Allows for tailored treatment plans to improve swallowing function and safety, potentially preventing complications like aspiration pneumonia.
• Immediate feedback on swallowing function.

Recovery

• Minimal recovery time; patients can usually resume normal activities shortly after the procedure.
• May need to follow specific dietary recommendations or swallowing techniques as advised by the speech-language pathologist.
• Follow-up appointments for therapy or additional assessments might be scheduled.

Alternatives

• Other Options: Fiberoptic Endoscopic Evaluation of Swallowing (FEES); an endoscopic procedure providing real-time images without radiation exposure.
• Pros and Cons: FEES is less invasive and involves no radiation but might be less comprehensive than a videofluoroscopic study in certain cases.

Patient Experience

• The patient might feel some anxiety or discomfort during and before the procedure.
• The taste and texture of barium can be unpleasant.
• Pain management and comfort measures, such as relaxation techniques, can help alleviate discomfort.
• The healthcare team will explain each step and provide support throughout the procedure.