Slikevaluatie

Slikevaluatie, or swallowing evaluation, is a clinical process used to determine whether a person has dysphagia, the severity of swallowing impairment, and the risk of aspiration during eating and drinking. It is conducted by healthcare professionals such as logopedists (speech-language pathologists), often in collaboration with physicians, radiologists, and dietitians. Slikevaluatie may be indicated for individuals who have experienced stroke, brain injury, neurodegenerative diseases, head and neck cancer, or other conditions affecting oropharyngeal function, as well as for residents of long-term care facilities or postoperative patients.

The evaluation typically comprises bedside and instrumental components. A bedside screening or clinical swallow evaluation assesses the patient’s ability to manage secretions, initiate a swallow, handle textures of varying thickness, and protect the airway, including observation of cough, voice quality, and residual food or saliva. Instrumental assessments provide a more detailed view of swallow physiology. The most common methods are videofluoroscopic swallow study (VFSS), which uses real-time X-ray imaging to visualize bolus movement through the mouth, pharynx, and esophagus, and fiberoptic endoscopic evaluation of swallowing (FEES), where a thin endoscope is passed through the nose to inspect laryngeal and pharyngeal structures during swallowing. Additional tests, such as esophageal manometry, may be used in select cases.

Outcomes of slikevaluatie inform decisions about diet modification, such as texture- or liquid-thickness alterations, swallowing therapy, compensatory strategies (postural adjustments), and safety precautions. The results guide multidisciplinary treatment planning and follow-up assessments. Limitations include variability in test sensitivity, patient cooperation, and resource availability, as well as exposure to radiation in instrumental studies.