[Dysphagia] dysphagia immediately s/p radation treatment

[EDolinger at Christianacare.org (Dolinger, Eric)]

Consider repeating the video - if not done already
Does he have hypopharyngeal or cervical esophageal radiation stenosis.  This
is not uncommon

Eric Dolinger, MA CCC-SLP
Senior Speech Pathologist
Christiana Care Health System 
Phone 302-733-1015
Fax 302-733-1061
edolinger at christianacare.org


-----Original Message-----
From: dysphagia-bounces at b9.com [mailto:dysphagia-bounces at b9.com] On Behalf
Of Julie Ennis
Sent: Friday, February 02, 2007 8:48 AM
To: dysphagia at b9.com
Subject: [Dysphagia] dysphagia immediately s/p radation treatment


I'll try to keep this brief, but I just wanted to see if anyone had any
other tidbit of advice or information...
 
59 y.o male.  3months out of radiation treatment for head/neck CA
(laryngeal), attempted to swallow but reportedly kept "bringing everything
back up". Had an MBS, (decreased base of tongue retraction and decreased
laryngeal elevation. Epiglottic inversion was incomplete.  Pharyngeal
residue was mild-moderate in the valleculae and  pyriforms  following all
consistencies.  Aspiration occurred during subsequent swallows of the thin
liquid and pudding, due to pharyngeal residue.  Cough was productive in
clearing pharyngeal residue as well as penetrated/aspirated material.
Penetration occurred with all consistencies due to pharyngeal residue. 
 
Now 5 months post radiation, and only able to keep 2-3 bites of thick puree
down, before "bringing it back up".  Patient has been completing pharyngeal
exercises (for what they are worth).  Patient continues to have a
significant amount of mucous.  He is convinced he would be able to swallow,
if he didn't have the mucous.  He has been given various medications by his
physicians to try to decrease the mucous without success. he hasn't had any
kind of GI work up yet... and seems a little reluctant to go this route
right now.  
 
1.Any suggestions on how else to decrease mucous?
2. patient has also asked about hyperbaric treatment.  does anyone have any
experience with this population and this treatment?
3.  Any other suggestions on how to proceed?  Other than just letting time
take its course?
 
thanks 
 
 
Julie Ennis, M.Ed, CCC-SLP
Sarasota Memorial HealthCare System
941-917-1395
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