Swallowing Disorders Center
Last updated: 02/20/2007
Scott Gibbs, MD
Cabell Huntington Hospital now has a designated swallowing disorders center located on the fourth floor of the hospital. The center is staffed by five certified and licensed speech language pathologists who perform the most recent state-of-the-art diagnostic and therapeutic services. Under the direction of otolaryngologist Scott Gibbs, MD, the center evaluates and treats patients with oropharyngeal dysphagia, which is defined as difficulty swallowing because of a problem in the mouth or throat. Dysphagia can occur as a result of head and neck cancer or from a neurological impairment including stroke, dementia, multiple sclerosis, Parkinson's Disease or closed head injury.
Diagnostic evaluations
Diagnostic evaluations performed in the center include the traditional modified barium swallow (MBS) performed in Radiology by the speech language pathologist and a radiologist; and the latest dysphagia diagnostic exam available at Cabell Huntington Hospital ? fiber-optic endoscopic evaluation of the swallow (FEES). Both tests may be performed on patients from infant to geriatric in age.
A FEES study is performed in the center by a speech-language pathologist as directed by Gibbs. A small, flexible scope is placed into the nose and positioned at the back of the threat to watch the swallow from above.
"The speech pathologist looks at the function of the structures of the swallow while the physicians is looking at the physical component to determine any abnormalities," said Martha Blenko, assistant director of rehabilitation and a speech language pathologist at the center. "Oftentimes, patients will undergo both an MBS and FEES, while some patients will have one or the other. The tests offer very different methods of evaluating the swallow."
Treatments
Once the patient's swallow has been evaluated and treatment is recommended, he or she may return to the hospital for the latest in dysphagia treatment, called Neuromuscular Electrical Stimulation (NMES). Using the FDA-approved VitalStim System to provide NMES, electrical stimulation is applied to the throat and facial muscles while the patient is actually eating or drinking. Treatment sessions last an hour and take place several days a week. After 12 to 15 sessions, the patient's swallow is reassessed for progress.
Deep Pharyngeal Neuromuscular Stimulation (DPNS) is another treatment used at Cabell Huntington Hospital to treat dysphagia. It involves swiping frozen swabs along the muscles of the mouth and throat to stimulate a swallow, gag or salivation. "This treatment is optimal if there is a sensory deprivation of the mouth and throat that is contributing to the dysphagia," Blenko said. The treatment lasts for about 45 minutes several days a week, with a reassessment after about a dozen sessions.
Traditional dysphagia therapy involves exercising the mouth and throat structures, and requires maximum effort from the patient in order for the treatment to be successful. "Ultimately, traditional exercises are incorporated with the Vital Stim and DONS methods" Blenko said. "It's even possible for a patient to receive a combination of all three treatments if it's required to meet the patient?s needs."
The FEES equipment used for evaluation is an excellent source for providing visual feedback to a patient during treatment, because the patient can use the monitor to watch himself or herself swallow and exercise the structures.
The center is open Monday through Friday from 8 a.m. to 4:30 p.m. Patients are seen after physician referral. For more information or questions about the center, call (304) 536-6335 or (304) 526-2077.
Contact Information:
| Phone: | (304) 536-6335 / (304) 526-2077 |