Swallowing Disorders
A swallowing disorder, or dysphagia, is difficulty moving food or liquid safely from the mouth to the stomach. It can make eating slow, unpleasant, or unsafe, and when material enters the airway it becomes a risk to the lungs.
Our approach
Swallowing sits at the same crossroads as voice: the larynx protects the airway during every swallow. That shared anatomy is why a voice and swallowing institute treats the two together, and why we assess swallowing by looking directly at what happens during it rather than by inference. Our approach is to diagnose precisely first, with instrumented evaluation, and then to match treatment to the specific breakdown, whether that is rehabilitation with a therapist, a procedure, or a change in how a patient eats.
We work alongside the neurologists, oncologists, and other physicians who often refer these patients, and we are clear about what can be improved and what can only be managed.
Who this is for
Dysphagia is common after stroke, in Parkinson's disease, ALS, and other neurological conditions, after head and neck cancer treatment, and with age. It also occurs after vocal fold paralysis, when airway protection is weakened. Patients and referring physicians come with coughing or choking during meals, food sticking, recurrent chest infections, or weight loss from eating difficulty.
What the assessment involves
Two instrumented tests anchor the assessment. Flexible endoscopic evaluation of swallowing (FEES) passes a thin endoscope through the nose to watch the swallow directly while the patient eats and drinks. Videofluoroscopy uses moving X-ray to see the whole swallow, including phases the endoscope cannot show. The two are complementary, and the choice depends on the question. The result identifies where the swallow is failing and how unsafe it is.
Evidence and experience
Instrumented swallowing assessment is standard practice in dysphagia care, and swallowing function is one of the institute's published research areas, including work in neurological and post-laryngectomy populations and on the diagnostic accuracy of swallowing screening in vocal fold paralysis.
What to expect afterwards
Many patients improve with swallowing therapy, targeted exercises, and adjustments to food texture and eating strategy, guided by what the assessment showed. Some causes are progressive, and here the goal shifts to keeping eating as safe and comfortable as possible for as long as possible. We are honest about which situation a patient is in, and we set the plan and the expectations accordingly.
Frequently asked questions
What is dysphagia?
Dysphagia is difficulty moving food or liquid safely from the mouth to the stomach. It can make eating slow or unpleasant, and when material enters the airway it becomes a risk to the lungs.
What is a FEES test?
Flexible endoscopic evaluation of swallowing, or FEES, passes a thin endoscope through the nose to watch the swallow directly while the patient eats and drinks. It shows where the swallow is failing and how unsafe it is.
What is the difference between FEES and videofluoroscopy?
FEES gives a direct endoscopic view of the swallow, while videofluoroscopy uses moving X-ray to show the whole swallow, including phases the endoscope cannot see. They are complementary, and the choice depends on the clinical question.
Can swallowing problems be cured?
Many improve substantially with therapy, targeted exercises, and adjustments to food texture and eating strategy. Some causes are progressive, and there the goal is to keep eating as safe and comfortable as possible for as long as possible.