The Modified Barium Swallow
- The oropharyngeal and pharyngeal
swallowing assessment, often known as a "modified barium swallow", is a
procedure that utilizes calibrated amounts of barium-coated "food",
usually in at least three consistencies, to assess the anatomy and
physiology of the oral and pharyngeal phases of swallowing.
- The examination is conducted jointly by
a radiologist and a speech pathologist.
- It is a fluoroscopic study which is
recorded on videotape (videofluoroscopy), which permits replay of the
examination in real time, as well as slow motion, and frame-by-frame
analysis of oral and pharyngeal function and dysfunction. Simultaneous
recording of sound permits documentation of the types and volumes of
foods given to the patient and the presence or absence of a cough reflex
in response to airway penetration or aspiration of ingested material.
- Throughout the assessment, the
fluoroscope should remain focused on the oral-pharyngeal region and
should not follow the bolus into the esophagus. Otherwise, aspiration
after the swallow may be missed.
- If the patient has been able to swallow
without significant aspiration, the esophageal phase of swallowing can
be evaluated at the end of the procedure.
NOTE: The procedure should terminated immediately if significant or
life-threatening airway penetration or aspiration is demonstrated. As
the physician member of the evaluation team, the radiologist is responsible for determining
when it is appropriate to prematurely discontinue the examination.
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