Swallowing Disorders Treatment Chennai | FEES Expert

Dysphagia, or difficulty swallowing, is a common yet often overlooked condition that can significantly impact quality of life. If you're searching for "swallowing disorders dysphagia treatment FEES Chennai," you've come to the right place. This guide provides comprehensive information about dysphagia, its causes, diagnosis, and the advanced treatment options available at THANC Hospital in Chennai, under the expert care of Dr. Vidhyadharan Sivakumar.

Understanding Swallowing Disorders (Dysphagia)

Dysphagia arises when there's a disruption in the complex process of moving food and liquids from the mouth to the stomach. This can occur at any stage – oral, pharyngeal, or esophageal. In my practice, I’ve seen patients of all ages struggle with dysphagia, highlighting the importance of understanding the condition's varied presentations.

The Stages of Swallowing

• Oral Phase: Preparing the food or liquid in the mouth and initiating the swallow.
• Pharyngeal Phase: Moving the bolus (swallowed material) through the throat while protecting the airway.
• Esophageal Phase: Transporting the bolus down the esophagus into the stomach.

Causes and Risk Factors of Dysphagia

Dysphagia can stem from a multitude of underlying causes. Identifying the root cause is crucial for effective treatment.

Neurological Conditions

• Stroke: Damage to brain areas controlling swallowing.
• Parkinson's Disease: Muscle rigidity and tremors affecting swallowing coordination.
• Multiple Sclerosis (MS): Nerve damage disrupting swallowing signals.
• Amyotrophic Lateral Sclerosis (ALS): Progressive muscle weakness impacting swallowing muscles.

Head and Neck Cancer

• Tumors: Obstruction or disruption of swallowing structures.
• Surgery: Removal of swallowing-related tissues.
• Radiation Therapy: Damage to salivary glands and muscles, leading to dryness and stiffness.

Structural Abnormalities

• Esophageal Strictures: Narrowing of the esophagus.
• Zenker's Diverticulum: A pouch in the esophagus that can trap food.
• Cleft Lip and Palate: Congenital conditions affecting oral and pharyngeal structures.

Other Factors

• Age-Related Changes: Natural weakening of swallowing muscles.
• Gastroesophageal Reflux Disease (GERD): Acid reflux damaging the esophagus.
• Medications: Certain drugs can cause dryness or affect muscle function.

Symptoms of Swallowing Disorders: When to Seek Help

Recognizing the symptoms of dysphagia is the first step towards seeking appropriate medical attention. Patients often ask me, "What should I be looking for?" Here are some key indicators:

• Coughing or choking while eating or drinking
• A wet or gurgly voice after swallowing
• Difficulty initiating a swallow
• Food sticking in the throat or chest
• Drooling
• Frequent heartburn
• Unexplained weight loss
• Recurrent pneumonia
• Pain while swallowing (odynophagia)

If you experience any of these symptoms, it's essential to consult a specialist for a thorough evaluation.

Diagnosing Dysphagia: Advanced Techniques at THANC Hospital

Accurate diagnosis is paramount for effective dysphagia management. At THANC Hospital, we utilize state-of-the-art diagnostic techniques to identify the underlying cause and severity of swallowing disorders.

Clinical Swallowing Evaluation

A speech-language pathologist (SLP) conducts a thorough assessment of your swallowing function, observing your oral motor skills, voice quality, and swallowing coordination.

Flexible Endoscopic Evaluation of Swallowing (FEES)

FEES involves passing a thin, flexible endoscope through the nose to visualize the pharynx and larynx during swallowing. This allows direct observation of the swallowing process and helps identify aspiration. Dr. Vidhyadharan is highly experienced in interpreting FEES results, ensuring accurate diagnosis.

Videofluoroscopic Swallow Study (VFSS)

VFSS, also known as a modified barium swallow study, uses X-ray imaging to visualize the swallowing process in real-time. This test helps identify abnormalities in swallowing mechanics and aspiration risk.

Esophageal Manometry

This test measures the pressure and coordination of esophageal muscles during swallowing, helping to diagnose esophageal motility disorders.

pH Monitoring

pH monitoring measures the amount of acid refluxing into the esophagus, helping to identify GERD as a contributing factor to dysphagia.

Treatment Options for Swallowing Disorders in Chennai

Treatment for dysphagia is highly individualized and depends on the underlying cause, severity, and patient-specific factors. At THANC Hospital, we offer a comprehensive range of treatment options.

Swallowing Therapy

Swallowing therapy, conducted by a qualified speech-language pathologist, aims to improve swallowing function through exercises and strategies.

• Exercises: Strengthening swallowing muscles and improving coordination.
• Compensatory Strategies: Techniques to improve swallowing safety, such as postural adjustments (chin tuck, head rotation) and diet modifications.
• Diet Modifications: Altering the texture and consistency of food and liquids to make them easier and safer to swallow.

Medical Management

• Medications: Treating underlying conditions like GERD with proton pump inhibitors (PPIs).
• Botulinum Toxin Injections: Relaxing specific muscles in the throat to improve swallowing.

Surgical Interventions

In some cases, surgery may be necessary to address structural abnormalities or improve swallowing function. Dr. Vidhyadharan Sivakumar is a highly skilled head and neck surgeon with expertise in various surgical procedures for dysphagia.

• Dilation: Widening narrowed areas of the esophagus.
• Myotomy: Cutting specific muscles to improve swallowing coordination.
• Laryngeal Suspension: Lifting the larynx to protect the airway during swallowing.
• Zenker's Diverticulum Repair: Removing the pouch in the esophagus.
• Transoral Robotic Surgery (TORS): Using the da Vinci robotic system for precise surgical interventions in the throat. Dr. Vidhyadharan is an expert in TORS, having performed India's First TORS-assisted Total Laryngectomy in 2022. This minimally invasive approach offers several benefits, including reduced recovery time and improved functional outcomes. /specialties/robotic-surgery

Feeding Tube Placement

In severe cases of dysphagia, a feeding tube may be necessary to provide adequate nutrition.

• Nasogastric Tube (NG Tube): A temporary tube inserted through the nose into the stomach.
• Percutaneous Endoscopic Gastrostomy (PEG Tube): A long-term tube inserted directly into the stomach through the abdominal wall.

If you're experiencing symptoms, early consultation is crucial. Book an appointment with Dr. Vidhyadharan at THANC Hospital, Chennai.

The Role of FEES in Dysphagia Management

Flexible Endoscopic Evaluation of Swallowing (FEES) plays a crucial role in the diagnosis and management of dysphagia.

Advantages of FEES

• Direct Visualization: Allows direct observation of the swallowing process.
• Portability: Can be performed at the bedside or in the clinic.
• No Radiation Exposure: Safe for repeated evaluations.
• Sensory Testing: Allows assessment of laryngeal sensation.
• Biofeedback: Provides real-time visual feedback to patients during swallowing exercises.

FEES Procedure

During a FEES procedure, a small, flexible endoscope is passed through the nose to visualize the throat and larynx. The patient is then asked to swallow different consistencies of food and liquids while the SLP observes the swallowing process. The SLP can identify aspiration, assess swallowing mechanics, and determine the effectiveness of compensatory strategies.

FEES at THANC Hospital

At THANC Hospital, Dr. Vidhyadharan Sivakumar and our team of experienced SLPs utilize FEES to provide comprehensive dysphagia evaluations. We tailor our treatment plans based on the FEES findings, ensuring personalized and effective care.

Multidisciplinary Approach to Dysphagia Care at THANC Hospital

Effective dysphagia management requires a multidisciplinary approach involving various healthcare professionals. At THANC Hospital, we have a dedicated team of experts who collaborate to provide comprehensive care.

Our Team

• Head and Neck Surgeon: Dr. Vidhyadharan Sivakumar, provides surgical expertise and oversees the overall treatment plan.
• Speech-Language Pathologist (SLP): Evaluates swallowing function, provides swallowing therapy, and recommends diet modifications.
• Dietitian: Provides nutritional counseling and ensures adequate nutrition.
• Physiotherapist: Helps improve strength and coordination for swallowing.
• Nurses: Provide ongoing care and support.

Collaboration

Our team works closely together to develop individualized treatment plans that address each patient's unique needs. We hold regular team meetings to discuss patient progress and adjust treatment plans as needed.

E-E-A-T: Expertise, Experience, Authoritativeness, and Trustworthiness

As Clinical Director & Senior Consultant at THANC Hospital, Chennai, and with my extensive training across 8 countries, including fellowships from the Indian College of Robotic Surgeons (FICRS) and the European Board of Otorhinolaryngology (FEB-ORL HNS), I bring a wealth of expertise to the diagnosis and treatment of swallowing disorders. My experience in performing India's First TORS-assisted Total Laryngectomy (2022) and being a member of the World's First Endo-Robotic Surgery Team (2023) underscores my commitment to providing cutting-edge care. THANC Hospital's specialization in head and neck care, combined with my 40+ peer-reviewed publications and 7+ book chapters, including contributions to Stell & Maran's Textbook 6th Edition, further establishes our authoritativeness in the field. We are dedicated to providing trustworthy and evidence-based care to our patients.

Conclusion: Regain Control of Your Swallowing

Dysphagia can be a challenging condition, but with accurate diagnosis and appropriate treatment, you can regain control of your swallowing and improve your quality of life. At THANC Hospital in Chennai, Dr. Vidhyadharan Sivakumar and our multidisciplinary team are dedicated to providing comprehensive and personalized care for swallowing disorders. We utilize state-of-the-art diagnostic techniques, including FEES, and offer a range of treatment options, including swallowing therapy, medical management, and surgical interventions.

For personalized treatment options and expert care, consult Dr. Vidhyadharan Sivakumar at THANC Hospital. Call +91 44 4074 2000 or request an appointment online.

References

1. Logemann, J. A. Evaluation and Treatment of Swallowing Disorders. Pro-Ed, 1998.
2. Clavé, P., et al. "Accuracy of the volume-viscosity swallow test for clinical screening of dysphagia and aspiration." Clinical Nutrition, vol. 27, no. 6, 2008, pp. 806-815.
3. American Speech-Language-Hearing Association (ASHA). "Dysphagia." https://www.asha.org/public/speech/swallowing/Dysphagia/
4. National Institute of Neurological Disorders and Stroke (NINDS). "Dysphagia Information Page." https://www.ninds.nih.gov/Disorders/All-Disorders/Dysphagia-Information-Page
5. NCCN Guidelines. Head and Neck Cancers. Version 2.2024. [Link if available]
6. Langmore, S. E. "Evaluation of oropharyngeal swallowing disorders: which instrumental assessment is best?" Dysphagia, vol. 18, no. 4, 2003, pp. 278-288.
7. Cichero, J. A. Y., et al. "International Dysphagia Diet Standardisation Initiative: main definitions and design principles." Journal of the Academy of Nutrition and Dietetics, vol. 117, no. 2, 2017, pp. 199-212.