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The Swallowing Program offers treatment focused on the evaluation, diagnosis and rehabilitation of swallowing disorders.
The program provides a multidisciplinary approach to otolaryngology and speech language pathology. An otolaryngology evaluation builds the framework for diagnosis of the swallowing disorder.
Speech language pathologists uses the diagnostic information to create a plan for safe swallowing and physical rehabilitation.
Common swallowing disorders include:
Acid Reflux
In this condition, stomach acid will reflux into to the esophagous and sometimes into the larynx and pharynx. This can cause inflammation of the lining; heartburn is common when the esophageal lining is inflamed, while symptoms, such as a dry cough or frequent throat clearing are common when the laryngeal mucosa is inflamed.
Trauma
Trauma that affects the brain can cause neurological problems that impair swallowing, while trauma to the neck can cause swallowing problems by changing the structure of the pharynx, larynx or esophagous.
Esophageal and pharyngeal stenosis
This refers to narrowing of the pharynx or esophagous. This can be caused a number of conditions including prolonged inflammation, trauma, and radiation to the neck.
Vocal Cord Paralysis
Vocal cord paralysis is a voice disorder that occurs when one (unilateral) or both (bilateral) of the vocal cords do not move. Normally our vocal cords move apart when we breathe and together when we talk. In unilateral paralysis, the paralyzed cord is usually in a position such that the normal cord cannot meet it during talking. This produces a gap between the cords and can cause symptoms such as a breathy voice, decreased loudness, and vocal fatigue. Treatment includes temporarily or permanently moving the paralyzed vocal cord to midline. Reinnervation, when another nerve is attached to the paralyzed nerve, can also give good results under certain conditions. In bilateral paralysis, both vocal cords are at the midline position and they cannot move apart during breathing. This usually produces airway obstruction, and the voice is much less affected. There are a variety of surgical procedures designed to treat bilateral vocal cord paralysis.
Zenker’s Diverticulum:
The most common symptom of Zenker’s diverticulum is difficulty swallowing food. Food may actually come back up out of the mouth several minutes to even hours after eating.Patients also suffer from choking, feeling mucus collecting in the throat, hoarseness, or bad breath. The symptoms can be quite embarrassing and debilitating.In patients with symptoms suggestive of Zenker’s diverticulum, a very simple and safe x-ray called a barium swallow is performed.
Neurological Diseases:
Stroke:
Dysphagia is often noted in stroke survivors. Usually, dysphagia affects the oral and/or pharyngeal phase of swallowing. The patient may cough or choke while attempting to swallow saliva, liquids or food. A phenomenon called silent aspiration also may occur, whereby saliva, food and liquids enter into the lungs without any coughing or choking. In these patients, there are no outward signs or symptoms of a swallowing problem. A speech-language pathologist often evaluates a patient’s ability to swallow safely, without food or liquid going into his or her airway/lungs and potentially causing bronchitis or pneumonia.
Parkinson’s Disease:
Many patients with Parkinson’s disease have dysphagia (difficulty swallowing) due to a loss of control of the mouth and throat muscles. This might make it difficult for the patient to chew and manage solid foods. A delay in the swallowing process in either the throat or pharynx (the digestive tube between the esophagus and mouth) might also make it difficult for the patient to swallow without coughing or choking.
Dysphagia increases the risk of aspiration (inhaling fluid or stomach contents) and pneumonia in patients with Parkinson’s disease. At times, making dietary changes and following special swallowing techniques are sufficient to improve the safety of swallowing. At other times, alternative means of providing fluids and nutrition are necessary.
Amyotrophic lateral sclerosis (ALS) (also known as Lou Gehrig’s Disease):
ALS is a progressive neurodegenerative disease that attacks nerve cells in the brain and spinal column. They control voluntary muscles, which in turn allow movement. Over a period of months or years, ALS causes muscle weakness, inability to control muscle movement that causes swallowing problems such as dysphagia.
Diagnostic procedures include:
In office:
Operative:
The program is housed in the UC Barrett Cancer Institute and the UC Physicians office at University Pointe in West Chester, Ohio.
For additional information:
University Voice and Swallowing Center
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