Name of the Procedure:

Complex dynamic pharyngeal and speech evaluation by cine or video recording

Summary

This procedure involves using cine or video recording techniques to assess the movement and function of the pharynx (throat) and speech mechanisms during various activities. This helps in diagnosing and managing speech and swallowing disorders.

Purpose

The main purpose of this evaluation is to identify abnormalities in speech and swallowing functions. It helps in diagnosing conditions such as dysphagia (difficulty swallowing), vocal cord dysfunction, or other speech-related issues. The expected outcomes include a clear diagnosis and a tailored treatment plan to improve the patient’s speech and swallowing abilities.

Indications

• Difficulty swallowing (dysphagia)
• Speech disorders or frequent voice changes
• Chronic throat pain or discomfort
• Suspected vocal cord dysfunction
• Nasal regurgitation of food or liquids

Preparation

• No specific fasting required unless otherwise directed.
• Patients may be asked to bring a list of medications and medical history.
• Prior diagnostic tests, such as a barium swallow or other imaging studies, may be reviewed.

Procedure Description

1. The patient is seated comfortably in a chair.
2. A small, flexible endoscope (camera) may be inserted through the nose or mouth to visualize the throat and vocal cords.
3. Cine or video recording devices capture the dynamic movements of the pharynx and speech structures while the patient performs specific speaking and swallowing tasks.
4. The video is analyzed in real-time and may also be reviewed later for detailed assessment.

Tools and Equipment:

• Flexible endoscope
• Cine or video recording equipment
• Microphones

Anesthesia/Sedation: Typically, no sedation is required, but a topical anesthetic may be used to numb the nasal passages.

Duration

The procedure usually takes about 30 to 60 minutes.

Setting

This evaluation is typically performed in a hospital outpatient department, a specialized clinic, or a speech and language therapy center.

Personnel

• Speech-language pathologist
• Otolaryngologist (ENT Specialist)
• Trained nurses or technicians

Risks and Complications

• Mild discomfort or gagging during the insertion of the endoscope
• Rare risk of nosebleeds
• Potential but rare complications like nasal or throat irritation

Benefits

• Detailed assessment leading to an accurate diagnosis
• Development of a customized treatment plan
• Improvement in speech and swallowing functions

Recovery

• Patients can usually resume normal activities immediately after the procedure.
• Mild throat discomfort may be experienced, which typically resolves within a few hours.
• Follow-up appointments may be scheduled to discuss results and treatment options.

Alternatives

• Standard speech and swallowing evaluations without video recording
• Radiographic swallowing studies (e.g., barium swallow)
• Clinical observation by speech therapists or ENT specialists

Pros and Cons of Alternatives:

• Non-video evaluations provide less dynamic and comprehensive data.
• Radiographic studies involve exposure to radiation.

Patient Experience

During the procedure, patients may feel mild discomfort during endoscope insertion, but it is generally well-tolerated. After the procedure, there may be a slight sore throat, which can be managed with over-the-counter pain relievers if necessary. Comfort measures, such as warm liquids or lozenges, can help alleviate any minor discomfort.