Abstract
This paper presents a detailed protocol for performing the videofluorographic swallowing study (VFSS), and describes how it evolved from its antecedents. The objectives of the VFSS are both diagnostic and therapeutic. Preparing for the VFSS is described, including the equipment, food preparation, and a brief discussion of the clinical evaluation. The detailed description of the VFSS procedure covers the position of the patient, the foods presented, the views obtained, modifications of feeding and swallowing that are commonly employed, the standardized set of observations, and reporting the results. Criteria for deviating from the protocol or aborting the study are presented. The VFSS does not necessarily end when a patient aspirates. Indeed, the complete evaluation of aspiration, and the effects of maneuvers designed to reduce it, is a major purpose of the VFSS. Modifications of feeding and swallowing are tested empirically during the study. The modifications include therapeutic and compensatory techniques that may improve the safety and efficiency of swallowing. A rationale for deciding which modifications to test in a given patient is discussed. The protocol has been used successfully in more than 350 patients. It has improved the efficiency and quality of our videofluorographic examinations.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Logemann JA:Evaluation and Treatment of Swallowing Disorders. San Diego: College-Hill Press, 1983
Gelfand DW, Richter JE (eds.):Dysphagia: Diagnosis and Treatment. New York: Igaku-Shoin, 1989
Linden PL, Siebens AA: Dysphagia: predicting laryngeal penetration.Arch Phys Med Rehab 64:281–284, 1983
Horner J, Massey EW: Silent aspiration following stroke.Neurology 38:317–319, 1988
Logemann JA:Manual for the Videofluorographic Study of Swallowing. Boston: College-Hill Press, 1986
Siebens AA, Linden PL: Dynamic imaging for swallowing reeducation.Gastrointest Radiol 10:251–253, 1985
Linden P: Videofluoroscopy in the rehabilitation of swallowing dysfunction.Dysphagia 3:189–191, 1989
Robbins JA, Sufit R, Rosenbek J, Levine RL: A modification of the modified barium swallow.Dysphagia 2:83–86, 1987
Curtis DJ: Radiologic examinations of the oropharyngeal region. In: Gelfand DW, Richter JE (eds.):Dysphagia: Diagnosis and Treatment. New York: Igaku-Shoin, 1989, pp 31–43
Ekberg O: Radiographic evaluation of swallowing. In: Groher ME (ed.):Dysphagia: Diagnosis and Management, 2nd ed. Boston: Butterworth-Heinemann, 1992, pp 163–195
Palmer JB, DuChane AS: Rehabilitation of dysphagia due to cerebrovascular disease.Phys Med Rehab Clin North Am 2:529–546, 1991
Siebens H, Trupe E, Siebens A, Cook F, Ansben S, Hanauer R, Oster G: Correlates and consequences of eating dependency in institutionalized elderly.J Am Geriatr Soc 34:192–198, 1986
Martin BJW, Corlew MM: The incidence of communication disorders in dysphagic patients.J Speech Hear Disord 55:28–32, 1990
Tippett DC, Palmer JB, Linden P: Management of dysphagia in a patient with closed head injury.Dysphagia 1:221–226, 1987
Siebens AA: Rehabilitation for swallowing impairment. In: Kottke FJ, Lehmann IF (eds.):Krusen's Handbook of Physical Medicine and Rehabilitation, 4th ed. Philadelphia: WB Saunders, 1990, pp 765–777
Palmer JB, DuChane AS, Donner MW: The role of radiology in the rehabilitation of swallowing. In: Jones B, Donner MW (eds.):Normal and Abnormal Swallowing: Imaging in Diagno sis and Therapy. New York: Springer-Verlag, 1991, pp 215–225
Palmer JB, Rudin NJ, Lara G, Crompton AW: Coordination of mastication and swallowing.Dysphagia 7:187–200, 1992
Silver KH, Palmer JB, Kuhlemeier KV: Timing of swallow onset during eating and drinking (abstract).Arch Phys Med Rehabil 73:979, 1992
Beck TJ, Gayler BW: Radiation in video-recorded fluoroscopy. In: Jones B, Donner MW (eds.):Normal and Abnormal Swallowing: Imaging in Diagnosis and Therapy. New York: Springer-Verlag, 1991, pp 1–6
Ekberg O: Posture of the head and pharyngeal swallow.Acta Radiol Diagn 27:691–696, 1986
Logemann JA, Kahrilas PJ, Kobara M, Vakil NB: The benefit of head rotation on pharyngoesophageal dysphagia.Arch Phys Med Rehabil 70:767–771, 1989
Kahrilas PJ, Logemann JA, Krugler C, Flanagan E: Volitional augmentation of upper esophageal sphincter opening during swallowing.Am J Physiol 260 (Gastrointest Liver Physiol 23): G450-G456, 1991
Coster S, Schwarz W: Rheology and the swallow-safe bolus.Dysphagia 1:113–118, 1987
Dantas RO, Kern MK, Massey BT, Dodds WJ, Kahrilas PJ, Brasseur JG, Cook IJ, Lang IM: Effect of swallowed bolus variables on oral and pharyngeal phases of swallowing.Am J Physiol 258:G675-G681, 1990
Author information
Authors and Affiliations
Additional information
Supported in part by awards #D000024 and #DC01575 from the National Institute on Deafness and other Communication Disorders.
Rights and permissions
About this article
Cite this article
Palmer, J.B., Kuhlemeier, K.V., Tippett, D.C. et al. A protocol for the videofluorographic swallowing study. Dysphagia 8, 209–214 (1993). https://doi.org/10.1007/BF01354540
Issue Date:
DOI: https://doi.org/10.1007/BF01354540