[Dysphagia] mbs clinical experience

[edagd at ath.forthnet.gr (LuckyLuk)]

I express my gratitude to the members of the list who responded to my 
question.
I assume that involvement or not of a team  ( at least two members) 
during the mbs procedure, depends rather on the expertise or the 
individuals. An inexperienced radiologist regarding anatomy , physiology 
and indications of the this particular dynamic instrumental examination, 
cannot help even a bit.
In contrary, an experienced one could help an inexperienced SLP in the 
introductory phase of the exam. However SLP s are trained to the 
implementation of the compensatory manouvers and modifications and are 
the only responsible for propose them during the mbs study.
I fully agree that mbs is not a one to one reproduction of the patient's 
feeding circumstances.
In my environment we try to reach that by using mostly food + barium 
formulas to the patient-preferably those foods that he/she likes the 
most. Moreover we try at least 2 swallows of each substance and if there 
is at least one doubtful observation , we try a 3rd and 4th one. That 
eliminates someway the statistical error of the examination.
My SLP s are the only "gold standards" supposing they have a full 
knowledge of the patients swallowing - feeding history and environ ment. 
A thorough and evidence based clinical swallowing -feeding evaluation is 
not to be replaced by an mbs.


Lukas Dagdilelis
Radiologist
Dysphagia Management Team
G. Papanikolaou hospital
Thessaloniki
Greece