Evaluation and treatment planning for the head-injured patient with oral intake disorders

The anatomic and physiologic swallowing disorders observed after head injury require careful physiologic assessment, usually via videofluoroscopy. The behavioral and neurolinguistic issues affecting oral intake require a detailed bedside or clinical examination. The bedside examination usually precedes videofluoroscopy and assesses oropharyngeal anatomy and oromotor and oral sensory function, as well as behavioral reactions and language/cognition levels. The videofluoroscopic examination defines the patient's basic swallowing physiology and determines the effects of volume, food consistency, posture, and selected therapy techniques on swallowing function. These examination procedures for head-injured patients are described in detail.