The Department of Speech and Hearing Science’s at Washington State University’s Elson S. Floyd College of Medicine received a new, top-of-the-line diagnostic tool to assess speech and swallowing disorders. A fiber-optic endoscope will not only put the latest technology in the hands of learners, but it will also provide more access to diagnostic care in our region.
An endoscope gives clinicians an inside look at a patient’s swallow function and vocal cord movement, enabling a faster and more accurate diagnosis and subsequent treatment plan.
“I equate it to an orthopedist who is going to treat a fractured leg or arm without getting an X-ray,” said Jennifer Kurtulus, MA, CCC-SLP, clinical supervisor in Speech and Hearing Sciences. “In the same way, we need imaging to be able to know what we’re diagnosing and treating.”
With the scope, speech-language pathologists (SLPs) can conduct a fiber-optic endoscopic evaluation of swallowing, which provides 3D, full-color imagery. Fiberoptic endoscopic evaluation of swallowing—also called FEES—is not a new test but it isn’t as widely used as other methods due to the training that goes into it.
Traditionally, SLPs use a modified barium swallow test, which uses X-rays to get a 2D, black-and-white view of swallowing. The modified barium swallow is typically done in a hospital setting and requires a radiologist as well as an SLP to interact with the patient and interpret the images.
Compared to traditional methods, FEES increases patient access to testing because it can be done in outpatient settings
“The benefit is that we are able to use this in a clinic or mobile setting,” said Kurtulus, who has more than a decade of experience using similar endoscope equipment in hospital and mobile settings. “That means using it in outpatient clinics, patient homes, nursing homes, and in more rural areas where we’re able to provide a different type of swallow evaluation to people that aren’t always able to access it.”
The flexibility and robotic nature of the scope make this model comfortable for both the patient and clinician, Kurtulus said. With a camera attached and controls to steer the scope, Kurtulus and other users can smoothly and painlessly insert the scope along the floor of the nose and into the back of the throat.
The camera shows what happens as a patient swallows in real time. Food or liquid can be introduced so SLPs see exactly what muscles are working, if there are any vocal cord pathology, and what treatment will best help the patient.
Due to its diagnostic value, fiber-optic endoscopic evaluation is often used to help patients with head and neck cancer, stroke victims, and patients with a neurological condition like ALS. The endoscope can also be used with a strobe light attachment—called videostroboscopy— to assess how the vocal cords are vibrating. This can help diagnose voice problems for professionals like teachers and singers who use their voice all day long.
The new equipment at WSU, made possible in part with philanthropic investment, will ensure students in Speech and Hearing Sciences are learning the newest and most effective way to help their future patients. The department received the equipment in the spring, and already graduate-level students have started using it in a practice setting.
The scope came with a head model which allows students to practice and get the hand-eye-coordination down to steer the probe. Graduate-level students in the swallowing disorder classes will get hands on experience using the scope on each other and volunteers.
The scope will also be a valuable new diagnostic tool for the Speech-Language Pathology Services Clinic operated by Range Community Clinic on the WSU Spokane campus. Currently, there is limited availability to this technology in the Spokane area, primarily through inpatient hospital services.
“We’re hoping to be able to serve the community in a really positive way because right now I know there’s a long waiting list for the hospitals,” added Kurtulus. “It’s going to be a true benefit for our clinic and our community.”