Videofluoroscopy


 * Videofluoroscopy (VFS) **

The videofluoroscopy uses barium laced food or liquid as a contrast agent, which the patient ingests. The swallow is captured by an x-ray video camera, where the barium shows up clearly as a bright white substance. As anatomical features such as bones and air cavities are also visible, it is possible for the assessor to analyse the physiology of the patient’s swallow, and the bolus’ transit from the mouth to the oesophagus (Logemann, 1993; Langley, 1988).

Videofluoroscopy is an effective way to assess whether or not patients with COPD have abnormal swallowing patterns compared to healthy patients. The following abnormalities can be identified by the VFS (Groher & Crary, 2010; Mokhlesi, Logeman, Rademaker, Stangl, & Corbridge, 2002):


 * Aspiration
 * The reduced elevation of the hyoid (and larynx)
 * Early and longer airway closure durations
 * Early airway closure relative to the opening of the cricopharyngeus
 * Abnormal flow through the cricopharyngeus
 * Bolus residue in the pharynx post swallow, indicating risk of aspiration
 * Penetration of food into the laryngeal vestibule

A VFS is also able to assess the effects of any compensatory techniques that a patient performs when swallowing. However, due to the patient’s exposure to radiation during the procedure, and the risk of barium aspiration, a VFS should be conducted only when necessary. media type="youtube" key="-wmt6HlLduY" height="390" width="640" An example of a videofluoroscopy.


 * References**

Groher, M., & Crary, M. (2010). //Dysphagia: Clinical management in adults and children//. Maryland Heights, MO: Mosby Elsevier.

Langley, J. (1988). //Working with swallowing disorders//. Bicester, England: Winslow Press.

Logemann, J. (1993). //Manual for the videofluorographic study of swallowing// (2nd ed.). Austin, TX: Pro-Ed.

Mokhlesi, B., Logemann, J., Rademaker, A., Stangl, C., & Corbridge, C. (2002). Oropharyngeal deglutition in stable COPD. CHEST, 121(2), 361-369.