Modified Monday: Where did that come from?
In case you missed our cat meme last week, it was a discussion of how important it can be to obtain some esophageal imaging during an MBS study. Just like magic, our Chicago team came through with a great example to share this week.
This patient had some clinical signs including occasional coughing and throat clearing, with a fairly significant decrease in PO intake and weight loss. During the study, it is evident that “something” is happening in the esophagus. There is backflow into the pharynx, which the patient subsequently aspirates with no independent cough or throat clear. Our SLP did a great job with the image and positioning, but the patient wasn’t quite able to get the shoulder positioned for a really adequate view in the lateral plane. The patient was turned A-P, and the SLP was then able to see that no Zenker’s appeared (Radiologist agreed), and there was slow clearing of the bolus through the esophagus. The patient was then scheduled with a GI consult. Clearly, the SLP would have recommended the GI consult regardless, but getting this information before the consult probably resulted in better care.
The saying “a picture is worth a thousand words” was spot on for this patient, as the facility physician, once seeing the actual images of the slow clear during the MBS, decided to directly send the patient for the GI consult, rather than trying to change meds, etc. Obtaining an image on the A-P plane can give both SLPs and Radiologists valuable information about pharyngeal symmetry and the movement of the bolus through the esophagus. See link below for more information!