By David Glick
Swallowing is a complex act. It takes more than 50 muscles and nerves working together to move food and drink from the mouth to the stomach. For many cancer patients, the disease or its treatment can hamper this highly coordinated process, threatening their recovery and quality of life.
Valerie Linane uses a new Digital Swallowing Workstation to check a patient’s swallowing ability. (Photo by Thomas Brown)
City of Hope now is one of a handful of institutions in California to offer patients who are at risk of swallowing problems some relief with new technology called a Digital Swallowing Workstation.
Known technically as dysphagia, impaired swallowing can lead to unhealthy weight loss, malnutrition, dehydration and pneumonia if liquid or food enters the airway.
Patients with head and neck cancers and esophageal cancers are particularly at risk for dysphagia. They often undergo multiple treatments including surgery, chemotherapy and radiation therapy that can change the body’s shape or function in ways that impair swallowing.
Speech and language pathologists in the Department of Rehabilitation Services such as Valerie Linane, working together with radiologists, can use the new Digital Swallowing Workstation to evaluate and treat these patients.
“The new video system greatly enhances our ability to evaluate and monitor the progress of our patients who have trouble swallowing following cancer intervention,” Linane said. “My patients can view the process on the computer monitor and see exactly what I’m seeing in real-time. This can ease their anxieties by empowering them as active participants in their own care.”
Patients stand or sit upright and the system records them from both the front and side. They swallow liquids and foods with a variety of consistencies: thin liquid barium, thick liquid barium, and pureed, soft and solid food coated with barium paste. The system records each swallow from the moment a substance enters the mouth until it passes into the esophagus.
Following the procedure, the clinicians show the patient and family members the recording. The equipment allows them to play back the exam at normal speed, in slow motion or frame-by-frame for a detailed look at swallowing difficulties. They address any swallowing issues and often recommend swallowing exercises and specific swallowing strategies or maneuvers to improve their swallowing function.
According to Linane, the swallowing workstation helps improve dysphagia diagnosis and treatment planning and allows clinicians to compare pre- and post-treatment swallowing side by side to more accurately check on a patient’s progress.
This system also has the ability to capture data for educational purposes and for future research, she said.
Ellie Maghami, M.D., chief of the Division of Otolaryngology/Head and Neck Surgery, expressed her approval of the new system.
“This workstation is an extremely useful diagnostic and rehabilitative tool, and I am delighted that we have access to technology that can empower us in caring for our patients with dysphagia,” she said. “This has been made possible through collaborations with our colleagues in diagnostic radiology, for which we are also very grateful.”
Maghami also lauded Linane and her colleagues. “Our entire rehabilitation department staff, including Ms. Linane, is an exceptional resource for our patients, and their contributions are essential to our treatment success and patient overall well-being,” she added.