Anatomic structures and sequence of swallowing

Swallowing function can be evaluated with a videofluoroscopic swallow study (VFSS), which is interpreted in real time by a speech-language pathologist and/or radiologist with special training in the technique. The examiner assesses the duration of oral and pharyngeal transit time, characterizes pharyngeal motility, and observes for signs of swallowing abnormalities including pooling of material in the vallecula and pyriform sinuses, residue in the pharyngeal recesses, and aspiration into the tracheobronchial tree. Laryngeal penetration is noted when food or liquid extends below the laryngeal surface of the epiglottis. Deep laryngeal penetration is noted when food or liquid reaches the level of the vocal folds, and aspiration occurs when food or liquid extends below the vocal folds into the tracheobronchial tree.