This patient, a 71 year old female, has a history of inoperable
cerebral aneurysm, hypertension, and trigeminal neuralgia. A
swallowing study performed approximately five months ago revealed
mild-moderate dysphagia with delayed initiation of the swallow reflex
and trace vestibular aspiration (penetration) before the swallow and
tracheal aspiration after the swallow. She limited her diet to soft
foods. She received swallowing therapy where she learned therapeutic
techniques. She reported using these consistently only during the
last several weeks. At the time of the current evaluation, she
complained of increased coughing and choking during oral intake. She
denies weight loss and does not demonstrate or complain of pulmonary
consequences of aspiration. The following swallowing evaluation was
performed to rule out progressive dysphagia and
aspiration.
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The patient was initially given 1/2 teaspoon of high density liquid barium. Observe the swallow to the right. During this swallow, which of the following was noted? Note: There may be more than one correct answer: A. Premature spillage into the pharynx before the swallow. B. Aspiration after the swallow. |