We know that dysphagia itself can be quite complicated (see our Modified Monday from a couple weeks ago), but today we discuss a case in which dysphagia was actually the complication. This patient recently underwent anterior cervical discectomy and fusion surgery and began demonstrating some clinical symptoms including coughing and throat clearing with PO, as well as complaints of difficultly swallowing. Dysphagia after this type of surgery is fairly common (see resources below) and usually (but not always) resolves after a few weeks.
This seems like a great time to chat about the cycle of dysphagia and complications-dysphagia itself is not a disease process, it is symptom of a disease process. In this case, a complication from a surgery. The point is-there is always a reason for the dysphagia... it doesn’t just happen on it’s own. Dysphagia in turn can then result in another disease process, like pneumonia or malnutrition.
We as SLPs can’t always do much to stop the first part of the cycle, the development of the dysphagia, but what we can do is make sure that we are accurately assessing the dysphagia once it happens to minimize the next part of the cycle-the subsequently developing complications. In the case here, the patient has no independent response to the aspiration (despite the clinical symptoms!) which often happens post ACDF surgery, so instrumental assessment is critical to adequately evaluate these patients.