1. Pooling of saliva at hypopharynx.
2. Reduced or absent of pharyngeal wall contraction upon prolonged/forceful phonation.
3. Rising tide signs which is regurgitation of refluxate emerging from upper oesophageal opening.
4. Reduced or absent adductor laryngeal reflex upon puff of air stimulaton or upon direct mucosal contact.
5. Panetration or direct observation of aspiration.
Obvious pooling of saliva at both pyriform fossa [(+) - bottom figure] in a patient who has an upper oesophageal stricture and anterior cervical fusion plates for fractures of cervical spine. Compare with normal appearance above.
Figure shows cumulation of saliva in the hypopharynx caused by pseudobulbar palsy. Dysphagia, dysphonia, and aspiration are the main issues that need wholesome management.
Glottic gap upon phonation Soft palate asymmetry.
obvious pooling of saliva, and
absent pharyngeal contraction.
FEES: Complete clearance of solid food (coloured rice grain).
FEES: Inability to clear colored food (pureed rice) upon act of swallowing.
FEES: Inability to swallow liquid even after several attempts.
Watch video of fungal oesophagitis by transnasal oesophagoscopy @ YouTube