Telefluoroscopy in Dysphagia Management - PowerPoint PPT Presentation

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Telefluoroscopy in Dysphagia Management

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Oral Transit of Food and ... Neurodegenerative Diseases-ALS, MS, PD, MG. Dementia, ... scopic. Examination. 3 Phases. Remote Expert Analysis. Remote ... – PowerPoint PPT presentation

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Title: Telefluoroscopy in Dysphagia Management


1
Telefluoroscopy in Dysphagia Management
James L. Coyle Communication Science
and Disorders University of
Pittsburgh
2
Speech Language Pathology
  • Diagnose and Treat
  • Communication Disorders
  • Motor Speech Disorders
  • Language Disorders
  • Cognitive Disorders
  • Voice Disorders
  • Swallowing Disorders

3
Swallowing Function
  • Oral Transit of Food and Liquid to Pharynx
  • Transfer of Food and Liquid through Pharynx to
    Esophagus
  • Nutrition
  • Hydration
  • Airway Protection to Avoid
  • Aspiration Related Disease
  • Choking

4
Swallowing Disorders (Dysphagia)
  • Dysphagia
  • 5-15 of Community Acquired Pneumonia are
    Aspiration Related
  • Neurogenic Dysphagia
  • Stroke-45-75
  • Traumatic Brain Injury-10-35
  • Neurodegenerative Diseases-ALS, MS, PD, MG
  • Dementia, Institutionalized Patients
  • Iatrogenic (caused by treatment of other
    conditions) Dysphagia
  • Adults and Children, Females and Males

5
Swallowing Disorders
  • Diagnosis of Oropharyngeal Dysphagia
  • Clinical Bedside Screening Examination
  • Diagnostic Instrumental Imaging Evaluation
  • Videofluoroscopy
  • Fiberoptic imaging (FEES, EGD)
  • Ultrasonographic Imaging
  • Nonimaging Instrumental Evaluation
  • Manometry, EMG, etc.

6
Diagnosis
  • Videofluoroscopic Diagnosis
  • Speech Pathologist
  • Radiologist
  • Solid Food, Liquid
  • Dynamic Assessment
  • Video, Digital Recording
  • Diagnosis
  • Therapy Planning

7
Swallowing Disorders
  • Biomechanical Analysis
  • Food is misdirected by biomechanical errors
  • And enters the lungs
  • Pneumonia, choking
  • Nutritional Compromise
  • Social Disadvantages
  • Dehydration
  • Medication Administration

8
Swallowing Disorders
  • Examiner Experience Varies
  • Rural Settings
  • Unusual Diagnoses
  • Unfamiliar Populations

9
Swallowing Disorders
  • Treatment Planning May Vary
  • Diet Modification
  • Behavioral Maneuvers
  • Enteral Tube Feeding

10
Telefluoroscopic Examination
  • Off the shelf hardware
  • Near-real time
  • Remote Expert
  • Data Analysis
  • Report Generation
  • Patient Database

Perlman, A.L., Witthawaskul, W. (2002). Real-time
Remote Telefluoroscopic Assessment of Patients
with Dysphagia. Dysphagia, 17, 162-167
11
Telefluoroscopic Examination
12
Telefluoro-scopic Examination
  • 3 Phases
  • Remote Expert
    Analysis
  • Remote Therapy
    Planning

13
Biomechanical Analysis
14
Imaging Interpretation
  • Advantages
  • Structural Abnormalities
  • Image Enhancement
  • Experience of Expert
  • Improve Precision
  • Remote Training

15
TreatmentPlanning
Diet Modification
Compensatory Strategies
Rehabilitation
Referral
16
Telemedicine and Dysphagia
  • Remote Home Monitoring
  • Follow Up
  • Modification of Plans without Clinic Visits

17
Telefluoroscopy
  • Goals Reduce Dysphagia Related Morbidity
  • ...in rural settings
  • ...for those without transportation
  • ...to reduce healthcare costs
  • ...and to improve access to expert clinicians

18
Thank You
  • Perlman, AL and Witthawaskul, W (2002). Remote,
    real-time, interactive, internet-based
    videofluoroscopic assessment of swallowing.
    American Telemedicine Association 2002
    Conference, Los Angeles, CA, June 6, 2002.

19
Telefluoroscopy in Dysphagia Management
James L. Coyle, M.A., CCC-SLP Communication
Science
and Disorders University of Pittsburgh
jcoyle_at_pitt.edu
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