Role of the modified barium swallow in management of patients with dysphagia.

The modified barium swallow is a radiographic (videofluoroscopic) procedure designed to define the anatomy and physiology of the patient's oropharyngeal swallow and examine the effectiveness of selected rehabilitation strategies designed to eliminate aspiration or excess oral or pharyngeal residue (the symptoms of the patient's dysphagia). Rehabilitation strategies introduced during the modified barium swallow after the patient's oropharyngeal anatomy and physiology have been defined include (1) postural changes to redirect food flow and change pharyngeal dimensions, (2) sensory enhancement techniques, and (3) swallow maneuvers. Combining the modified barium swallow with a follow-up swallowing rehabilitation plan can decrease the cost and time for rehabilitation of patients with dysphagia. In some cases the patient can begin safe oral intake immediately after the modified barium swallow, and therapy may not be needed if consistent spontaneous recovery is anticipated.