Videofluoroscopy for the Diagnosis of Dysphagia

Dysphagia, or difficulty swallowing, affects a wide variety of patients and can result from various neurological, mechanical, or structural conditions that alter the normal functioning of the swallowing process. At FIVAN, we understand the complexity of this condition and offer a cutting-edge diagnostic tool: videofluoroscopy.

What is Videofluoroscopy
and how is it performed?

Videofluoroscopy is a real-time diagnostic imaging technique that uses X-rays to visualize the act of swallowing. This tool allows us to observe the transit of a bolus of food, usually mixed with a radiopaque contrast such as barium sulfate, from the mouth to the esophagus, providing a detailed view of the oral and pharyngeal phases of swallowing.

Videofluoroscopy is a specialized study that is carried out in a clinical setting and requires an interdisciplinary team. The general steps of how a videofluoroscopy is performed:

Patient Preparation

Before starting the procedure, the patient is informed about the examination, their medical history is reviewed, and they are given instructions on how to proceed. It is important that the patient fast for a few hours before the examination to minimize the risk of aspiration.

Preparation of Contrast Material

A bolus of food is prepared mixed with a radiopaque contrast material, usually barium-based, which is safe for the patient and visible on X-rays. This material can be mixed with different food textures, from liquids to solids, depending on what you want to evaluate.

Patient Positioning

The patient stands or sits laterally in front of a fluoroscope, which is an X-ray device that allows real-time visualization of the anatomy. They may be asked to wear a lead apron to protect other parts of the body from radiation exposure.

Study Performance

Once the patient is ready, they are instructed to swallow the prepared bolus of food. The radiologist and speech therapist observe on a screen the path of the contrasted bolus through the different phases of swallowing: oral, pharyngeal, and esophageal.

During the procedure, different tests can be performed, such as asking the patient to swallow bites of different sizes or textures, to assess how they handle different types of food.

Analysis of Results

The team observes whether there is any residue in the mouth or pharynx after swallowing, whether the bolus moves correctly through the esophagus, or whether there are signs of penetration into the larynx or aspiration into the trachea, which would be indicative of a risk of aspiration pneumonia.

Post-Procedure

After the test, the patient or family is informed about the initial findings and given follow-up instructions or dysphagia rehabilitation.

Indications for Videofluoroscopy

Videofluoroscopy is indicated for patients who present symptoms of dysphagia, which may be evident in people with:

Cerebrovascular accidents (CVA): Patients who have suffered a stroke and show signs of dysfunction in the coordination of the muscles involved in swallowing.
Neurodegenerative diseases: Such as Parkinson’s disease, multiple sclerosis, or amyotrophic lateral sclerosis (ALS), where progressive deterioration can affect the ability to swallow safely.
Traumatic brain injuries: Injuries to the brain that can affect the areas responsible for the reflex and voluntary act of swallowing.
Head and neck cancer: Both the disease and the treatments, such as surgery or radiotherapy, can alter the anatomy or functionality of the swallowing structures.
Congenital or acquired anomalies: Such as the presence of cleft palates or surgeries that alter the anatomy of the upper digestive tract.
Muscular diseases: That affect the strength and coordination of the swallowing muscles, such as myasthenia gravis.
Psychological or behavioral disorders: That may manifest with symptoms of dysphagia.

Benefits of the Study

Performing videofluoroscopy provides significant advantages:

Accurate Diagnosis: Allows identifying the stage of swallowing in which the problem is found and the nature of the problem.
Individualization of treatment: Facilitates the development of a personalized treatment plan adapted to the specific needs of each patient.
Prevention of complications: Helps prevent aspiration pneumonia and malnutrition by detecting early penetration or aspiration of food.
Progress evaluation: Serves as a tool to monitor the patient’s evolution and the effectiveness of the therapeutic interventions implemented.

At FIVAN, we have an interdisciplinary team of specialists including neurologists, radiologists, speech therapists, occupational therapists, and physiotherapists, committed to the comprehensive care and improvement of the quality of life of our patients with dysphagia.

If you suspect that you or a loved one may be experiencing difficulties with swallowing, or if you already have a diagnosis of dysphagia, videofluoroscopy may be the next step towards an effective and safe recovery.