The Modified Barium Swallow Study and Esophageal Screening: A Survey of Clinical Practice Patterns

Area of Science:

• Otorhinolaryngology
• Medical Imaging
• Speech-Language Pathology

Background:

• Modified barium swallow study (MBSS) is a videofluoroscopic evaluation of oropharyngeal swallowing.
• While visualizing esophageal bolus flow during MBSS is permitted, its implementation lacks consensus and standardized guidance, leading to practice variations.

Purpose of the Study:

• To describe current practice patterns of speech-language pathologists visualizing esophageal bolus flow during MBSS.
• To understand variations in incorporating esophageal visualization into MBSS.
• To determine clinicians' willingness to modify MBSS procedures for esophageal imaging.

Main Methods:

• A web-based survey was distributed to members of the American Speech-Language-Hearing Association Special Interest Group 13 and Dysphagia Café.
• The survey consisted of 26 questions and was open for 3 months, with field-testing for content validity.

Main Results:

• 93% of 265 respondents visualized the esophagus during MBSS, with significant variability in the extent of visualization (proximal to lower esophagus).
• Variability was also noted in contrast type, volume, and nomenclature used.
• Few participants disagreed with performing esophageal visualization during MBSS.

Conclusions:

• Speech-language pathologists are enthusiastic about expanding MBSS to include esophageal visualization.
• Lack of uniformity in current assessment practices may impact diagnostic accuracy and clinical utility.
• A standardized protocol is needed to address barriers and controversies in expanding MBSS for comprehensive dysphagia evaluation.