Medical history: 63 year old female with HTN, HLD, COPD, tobacco use, anxiety, depression, heart disease, severe cervical spine stenosis requiring surgery, and neurogenic bladder. Pt was received 2 LPM O2 via nasal cannula.

Current diet:  NPO/PEG

HINTS

Watch the video, then open the VIEW HINTS tab to see any available hints prior to viewing the results.

HINTS: 

Notice the long uvula.

Did you notice the stringy secretion at baseline, which cleared w/ po intake?

VIEW RESULTS 

Open the VIEW RESULTS tab below after making your own interpretation.

Summary: 

Patient-8-Summary

 

Pt presents with mild pharyngeal dysphagia c/b: mildly reduced hyolaryngeal excursion and reduced pharyngeal constriction. This resulted in trace to moderate pharyngeal residual.. Note that reduced mastication is a result of incomplete dentition as pt’s lower denture recently broke (per pt and spouse). No penetration or aspiration observed with any consistency presented. Observed residuals in the valleculae and pyriforms as well as posterior pharyngeal wall ranging from trace to moderate. Residuals cleared with both reflexive subsequent swallows and/or thin liquid wash. Use of straw was not observed to negatively affect swallow function. Note that swallow trigger with juice from mixed consistency and thins is within normal limits. Endoscopic findings included laryngeal edema and erythema, which may be suggestive of laryngopharyngeal reflux.

Recommendations:
Diet:  Mechanical Soft/Thin Liquids
1. Sit upright with all intake.
2. Small bites/sips. One bite/sip at a time.
3. Alternate liquids/solids
4. Straw are okay.
5. Monitor for s/sx aspiration pneumonia.
6. Consider reflux management including diet, behavioral modifications and/or medication, as appropriate.