Gastrointestinal Radiology > Procedures > Barium Swallow > Modified (6)


The Modified Barium Swallow (cont.)

Reporting Findings 

Be as specific as possible.

For instance, it is of only limited help to the clinician if you report that “the patient aspirated barium.” Attempt to identify and report the reason or reasons: inadequate laryngeal elevation, poor epiglottic deflection, incomplete stripping by the pharyngeal constrictors, etc. Indicate whether the aspiration occurred during swallowing, before the event, or afterward. Describe the depth of the penetration or aspiration: supraglottic, laryngeal, or subglottic. Report whether the aspiration evoked a response, such as coughing, throat-clearing, etc. or was without a reaction (“silent aspiration”).

Correctly use the terminology used by specialists interested in dysphagia:

Penetration - At U. Va., the term applies to entrance of “food” into the larynx—beyond the glottic opening but not beyond the true vocal cords. (In some centers, “penetration” is used to indicate the passive entrance of material into the airway.)

Aspiration - At U. Va., the term is used to indicate the passage of “food” beyond the true vocal cords into the trachea. (In some centers, “aspiration” is used to indicate the inhalation of material into the airway during the inspiratory phase of breathing; i.e., the material is actively sucked into the airway.)

Silent aspiration or penetration - when there is no protective cough or compensation

Compensation, compensatory strategy - a patient’s mechanism for coping with impaired swallowing

Decompensation - when there is failure of compensation for swallowing impairment
 

 


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