instruments/assessments, aspiration, swallow techniques

Videofluoroscopic Swallow Study (VFSS)/MBSImP

Provides direct visualization of the bolus throughout the oral, pharyngeal, and esophageal swallow phases

common use: Detailed analysis of oropharyngeal swallow function; identifies abnormalities in swallowing mechanics, used for comprehensive diagnostics.

Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Provides direct visualization of the bolus during portions of the pharyngeal phase of the swallow

common use: Assessing swallowing function directly, especially useful for observing laryngeal closure, penetration, and residue without radiation exposure.

Cervical Auscultation

Provides auditory information about the pharyngeal phase of the swallow

Surface Electromyography (sEMG)

Provides indirect visual information about muscle activity during the oral and pharyngeal phases of the swallow

Yale Swallow protocol

Combines an oral-motor examination, a cognitive screening, and the 3-ounce water swallow test

common use: Comprehensive initial screening to evaluate risk of aspiration pneumonia in adults.

Penetration-Aspiration Scale (PAS)

An 8-point scale that quantifies the severity of penetration (entry of material into the laryngeal vestibule) and aspiration (entry of material below the vocal folds) during swallowing.

common use: Assessing the severity of penetration and aspiration

3 ounce water swallow test

A patient drinks 3 ounces of water without stopping. Failure is indicated by inability to complete the task or signs of aspiration (like a "wet" voice or cough).

common use: Screening for dysphagia; quick, initial assessment to identify potential swallowing problems.

aspiration

The act of inhaling food, liquid, or other foreign materials into the airway or lungs, which can lead to respiratory complications such as aspiration pneumonia.

penetration

The entry of material into the airway but not below the vocal folds, which may indicate a risk of aspiration.

silent aspiration

Aspiration of food or liquid into the airway without any observable signs, such as coughing or choking, making it particularly dangerous as it may go unnoticed.

effortful swallow

why its used: A stronger-than normal swallow to help clear stuff out of your throat.

helps with: Food sticking in your throat (valleculae) or pharyngeal pressure, weak tongue or pharynx muscles.

mendelsohn maneuver

why its used: You “freeze” your swallow at the top to hold your voice box up longer.

helps with: Trouble opening the top of the esophagus or poor timing when swallowing.

supraglottic swallow

why its used: Hold your breath, swallow, then cough to protect your airway.

helps with: If stuff is going into the airway due to a slow or weak swallow.

Super-Supraglottic Swallow

why its used: Same as supraglottic swallow but add bearing down like you’re lifting something heavy.

-main goal is to protect airway by closing true and false vfs

chin tuck

why its used: Tuck your chin down while swallowing. This narrows the airway and gives you more control.

helps with: If swallowing is delayed or food collects above the airway.

head turn

why its used: Turn your head to one side to send food down the stronger side of your throat.

helps with: One side of the throat is weaker than the other.

masako maneuver

Place your tongue tip between your teeth and then swallow.

-increases strength of base of tongue

shaker exercise

A chin tuck exercise that involves lifting the head while lying down. Main goal is to improve the opening of UES