By Peter C. Belafsky
The Clinician’s advisor to Swallowing Fluoroscopy is a accomplished source for all dysphagia clinicians. This beautifully-illustrated textual content is meant for SLP, ENT, radiology, GI, and rehabilitation experts drawn to swallowing and addresses the necessity for an updated, all-inclusive reference. issues coated contain radiation safeguard and safety, fluoroscopic oral, pharygeal, and esophageal part protocols and abnormalities, and goal measures of timing and displacement.
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Extra resources for The Clinician's Guide to Swallowing Fluoroscopy
Although the LES relaxes with the initiation of the pharyngeal swallow on manometry, the LES does not open on fluoroscopy until it is distended by an advancing bolus. The normal swallow-induced esophageal contraction is referred to as primary peristalsis. 7). A normal esophageal stripping wave transmits a bolus at approximately 2 cm/s. Thus, a bolus should clear the normal 25 cm esophagus in less than 15 s. Liquid barium should proceed throughout its entire length in one smooth motion. Barium tablets may proceed more rapidly in an upright individual as transit may bypass peristalsis and the tablet may drop into the stomach by gravity alone.
2b). 3b). Total pharyngeal transit time is the simple addition of both times. 1. Prolonged pharyngeal transit times increase the duration that a bolus may threaten the airway and are associated with a significantly increased risk of aspiration pneumonia. 54 7 Objective Measures on Videofluoroscopic Swallow Studies Fig. 2 Lateral fluoroscopic views for determining oropharynageal transit time. (a) The time when the head of the bolus (white dotted line) first passes the posterior nasal spine ( white asterisk) is subtracted from (b) the time when the head of the bolus ( white dotted line) enters and exits the base of the vallecula ( black arrow) Fig.
Belafsky, M. A. 1007/978-1-4939-1109-7_5, © Springer Science+Business Media New York 2014 31 32 Fig. 1 Region of the upper esophageal sphincter (UES). IPC inferior pharyngeal constrictor; CPM cricopharyngeus muscle. (Gray, Henry. Anatomy of the Human Body. Philadelphia: Lea and Febiger 1918) Fig. 2 Region of the upper esophageal sphincter (UES) on lateral fluoroscopy. TVF true vocal fold 5 Normal Pharyngoesophageal Segment Fluoroscopy Normal PES Opening 33 Fig. 3 Anatomic structures in lateral fluoroscopic view.