The clinical examination of swallowing includes taking the medical history (which is used to identify the clinical signs of dysphagia), a physical examination of oral anatomy and oropharyngeal function, and an observational assessment of swallowing function.
A functional examination of the structures involved in swallowing is used to assess their tone at rest, strength, resistance and degree of mobility. Unless contraindicated, we end with an examination with foods, assessing different viscosities (liquid, nectar and pudding) with increasing volumes of bolus. For each act of swallowing the following parameters are assessed: ability to maintain the bolus in the mouth, chewing and manipulation of food (this is clearer with the pudding viscosity or solid foods), laryngeal elevation, nasal or tracheal regurgitation, voice quality (appearance of wet voice after swallowing), appearance of post-swallowing cough and residue in the oral cavity.
In many cases we can start suitable treatment strategies for patients after this examination. In other patients we will request specific investigations.