The first time I saw a swallow of a person with a total laryngectomy, I had to review the still picture for several minutes, just to orient myself. We get so used to everything looking a certain way, it can throw you for a loop if you don’t know what you’re looking at. In this video, we see two swallows, one of thin, and one of nectar.
And… yes….because it’s a total laryngectomy, there is no chance there will be aspiration (unless the patient has developed a fistula - see our prior MM for a great example of that). However, since dysphagia can be present without aspiration, it’s still important to assess.
This particular patient was eating very little by mouth, complaining of food and pills getting stuck. We can see in this clip how much of the bolus is remaining in the pharynx, taking several swallows to clear. In this case, a basic alternating of solids and liquids and an effortful swallow, along with smaller more frequent meals (rather than 2-3 larger meals) was fairly effective for this patient. See the links below for info!