PMC9927700_01
Fiberoptic Endoscopic Evaluation of Swallowing. Structural assessment demonstrating (A) spherical bulging of the posterior wall of the oropharynx, extending anteriorly towards the soft palate and base of the tongue and narrowing the aerodigestive pathway. Functional evaluation with solid consistency showing (B) nasal reflux of food and (C) ineffective clearance with food residue on the lesion after 3 swallows
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Fiberoptic Endoscopic Evaluation of Swallowing (FEES) was performed, with bulging of the posterior wall of the hypopharynx visualized in the structural evaluation, with salivary residue on the lesion (Figure 1).
Neck computed tomography, sagittal (A) and axial (B) sections, showing cervical osteophytes from C3 to C6, the largest (arrow) measuring 12mm in the anteroposterior diameter
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Computed tomography (CT) of the cervical spine was requested to assess the nature of the lesion, showed the presence of anterior cervical osteophytes between the C3 and C6 vertebrae, the largest with an anteroposterior length measuring 12 millimeters (mm), narrowing the air column at the ear level - and hypopharynx (Figure 2).
Fiberoptic Endoscopic Evaluation of Swallowing after speech therapy. Functional evaluation with chin tuck maneuver, (A) before swallowing, showing an increase in the pharyngeal and vallecular space by the maneuver, and (B) during swallowing, with a decrease in nasal reflux of food
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After the initial sessions, the patient showed a satisfactory response (Figure 3), maintaining quarterly follow-ups in the first year and every six months from the second year onwards.