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Non-instrumental swallowing assessment and evaluation

Clinical swallowing evaluation – non-instrumental

This evaluation includes a detailed case history, an assessment of the motor and sensory function of the cranial nerves involved in swallowing, and an observational assessment of your eating and drinking. It provides the clinician with vital information that helps guide treatment recommendations and/or need for instrumental swallowing assessment.

Cough reflex testing

Cough reflex testing is part of the cranial nerve examination included in our non-instrumental clinical swallowing evaluation. It indicates if a person likely to be able to clear food or fluid from their airway.

Instrumental swallowing assessment and evaluation

Videofluoroscopic Swallowing ΢��ҕ�l (VFSS)

A Videofluoroscopic Swallowing ΢��ҕ�l (VFSS) is a moving x-ray of swallowing. It enables the speech-language therapist to assess the physiology of your swallowing, your swallowing safety, and guides management and treatment of your swallowing disorder. No special preparation is required prior to the procedure.

We are the only private clinic in New Zealand to offer VFSS. We have our own Fluorostar system on-site and our clinicians are trained in Radiation Safety and have a radiation use licence. In addition, Dr Anthony Lim is available as a consulting radiologist when required. A detailed diagnostic report is provided and if applicable treatment options discussed based on the findings of this assessment.

You can find more information about VFFS in this ‌VFSS Information pamphlet.

Flexible Endoscopic Evaluation of Swallowing (FEES)

Videoendoscopic Endoscopic Evaluation of Swallowing (VEES) uses a flexible nasendoscope to assess swallowing. The nasendoscope is passed through your nose until the throat is in view. You are given food and drink, dyed with food colouring, to eat and drink whilst the nasendoscope is in place; this facilitates direct visualisation of your throat to enable assessment of your swallowing. VEES is unique, in that it also enables the assessment of how you manage your saliva. VEES can also be used to provide biofeedback as you participate in swallowing rehabilitation.

Low Resolution Pharyngeal Manometry (LRM)

Low Resolution Pharyngeal Manometry (LRM – pharyngeal) evaluates pressures in the throat when swallowing. There are 3 pressure sensors that measure the pressure at: 1. the level of the base of tongue to posterior pharyngeal wall approximation; 2. laryngeal additus, and 3. uppermost border of the cricopharyngeus muscle.  This provides us with information about pharyngeal pressure timing and amplitude, and the co-ordination of swallowing pressures.

In addition to its role in evaluation, LRM- pharyngeal can provide visual biofeedback during rehabilitation. For example, it can provide visualization of the sequencing of swallowing pressures, and patients can train to re-sequence these pressures during swallowing with this unique biofeedback tool.

Other common diagnostic techniques, such as fluoroscopy and endoscopy, rely on a clinician’s subjective interpretation of moving images for diagnosis. Pharyngeal manometry, contrastingly, provides quantitative data that can be measured and compared in an objective manner. 

Ultrasonography

Ultrasound uses high frequency sound pressure waves to visualise internal body structures and movements. Ultrasound offers many advantages compared to other imaging techniques as it is non-invasive, safe, relatively inexpensive, and portable, making it ideal for use in rehabilitative medicine. In swallowing rehabilitation, ultrasound can give clinicians information about the size of the muscles involved in swallowing (under the chin) as well as biomechanical changes during swallowing.