Swallowing Disorders after Oral Cavity and Pharyngolaryngeal Surgery and Role of Imaging

Table 2

(a) Logemann’s worksheet for preparation to swallow in lateral view. (b) Logemann’s worksheet for oral phase in lateral view. (c) Logemann’s worksheet for pharyngeal and esophageal phases in lateral view. (d) Logemann’s worksheet for pharyngeal phase in anteroposterior view.

(a)

Lateral view	Consistency of food
Preparation to swallow	Amount of bolus	Possible swallowing disorders
Cannot hold food in mouth anteriorly		Reduced lip closure
Cannot form bolus		Reduced tongue movement rage or coordination
Cannot hold bolus—premature bolus loss; Aspiration (%) before swallow		Reduced tongue shaping/coordination; reduced velar movements
Material falls into anterior sulcus		Reduced labial tension
Materials falls into lateral sulcus		Reduced buccal tension
Abnormal hold position		Tongue thrust; reduced tongue control
Posture introduced

(b)

Lateral view	Consistency of food
Oral phase	Amount of bolus	Possible swallowing disorders
Delayed oral onset of swallow		Apraxia of swallow; reduced oral sensation
Searching tongue movements		Apraxia of swallow
Tongues moves forward to start to swallow		Tongue thrust
Residue in anterior sulcus		Reduced labial tension; reduced lingual control
Residue in lateral sulcus		Reduced buccal tension
Residue on floor of mouth sulcus		Reduced tongue shaping or coordination
Residue in midtongue depression		Tongue scarring
Residue on tongue		Reduced tongue movement and strength
Disturbed lingual contraction		Disorganized A-P tongue
Incomplete tongue-palate contact		Reduced tongue elevation
Residue on hard palate		Reduced tongue elevation and strength
Reduced A-P tongue movement		Reduced A-P lingual coordination
Uncontrolled bolus/premature swallow		Reduced tongue control; reduced linguavelar seal
Aspiration (%) before swallow		Reduced tongue control
Piecemeal deglutition
Oral transit time
Posture/treatment introduced

(c)

Lateral view	Consistency of food
Pharyngeal phase	Amount of bolus	Possible swallowing disorders
Nasal penetration		Reduced velopharyngeal closure
Pseudoepiglottis (total laryngectomy)
Coating on pharyngeal walls after swallow		Reduced pharyngeal contraction
Vallecular residue (%) after swallow; Aspiration of this (%) after swallow		Reduced tongue base posterior movement
Coating in depression on pharyngeal walls; Aspiration of this (%) after swallow		Scar tissue; pharyngeal pouch
Residue at top of airway		Reduced laryngeal elevation
Aspiration of this (%) after swallow
Penetration into airway entrance; Aspiration of this (%) after swallow		Reduced laryngeal elevation/reduced closure of airway entrance
Reduced laryngeal closure; Aspiration of this (%) after swallow		Reduced closure of airway entrance
Aspiration during swallow		Reduced laryngeal closure
Residue in both pyriform sinuses; Aspiration of this (%) after swallow		Reduced laryngeal anterior notion, cricopharyngeal dysfunction, stricture
Residue throughout the pharynx; Aspiration of this (%) after swallow		Generalized reduced pression during swallow
Pharyngeal transit time
Posture introduced
Cervical esophageal phase
Esophageal-to-pharyngeal backflow
Tracheoesophageal fistula
Other

(d)

Anteroposterior view	Consistency of food
Pharyngeal phase	Amount of bolus	Possible swallowing disorders
Unilateral vallecular residue		Unilateral dysfunction of tongue base
Residue in one pyriform sinus		Unilateral dysfunction of pharynx
Reduced laryngeal movement medially		Reduced adduction
Unequal height of vocal folds
Posture introduced