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The USC Swallowing Center is a dedicated multidisciplinary group based in the Department of Surgery, devoted to the study and treatment of patients who have difficulty swallowing food or drink. Swallowing is almost the first thing a baby learns to do after birth, and it is so instinctive that the finely coordinated complex mechanism is hard to appreciate until something goes wrong. Over 22 muscles controlled by six pairs of cranial nerves are necessary to control the whole process. When defects develop, patients usually are conscious of difficulty in eating or drinking, but sometimes the symptoms are dominated by related abnormalities, such as choking episodes when eating, recurrent attacks of pneumonia, voice changes, and inability to maintain body weight and nutrition. The quality of life of such patients is very poor. They often find it hard to obtain worthwhile medical help because the disorders are often complex and do not fit neatly into the center of any traditional specialty. To understand dysfunction in this area therefore requires access to skilled personal in a dedicated swallowing function laboratory. Surgeons of the USC Thoracic and Foregut division along with other members of the Swallowing Center are on the forefront of diagnosis and treatment for patients with swallowing disorders. One key to the success of the Swallowing Center is the sophisticated and highly modernized laboratory that provides Swallowing Center physicians with the unique capability of examining the pressure profile of a swallow simultaneously while viewing the image of that same swallow during a barium video X-ray study. This allows members of the Swallowing Center to review the mechanics of each swallow in precise detail, and pinpoint the cause of the dysfunction. The lab also has the equipment to examine the swallowing process with a small video camera placed through the nose. Because of this specialized equipment and the experience of the Swallowing Center team, in most cases the cause of swallowing dysfunction can be determined even in patients whose previous investigations elsewhere were thought to be normal. Furthermore, the Swallowing Center team is able to characterize the cause of the problem in patients whose swallowing disorder is secondary to a stroke, radiation therapy, head and neck surgery, Parkinson's disease, muscular dystrophy or some other neuromuscular condition. This type of technology, as well as skilled nurses and physicians to interpret the results, is available on the West Coast only at USC. Once a diagnosis is made, Swallowing Center physicians and the patient work out a treatment plan best suited for that individual patient. In some instances swallowing disorders are corrected non-surgically. One technique, using biofeedback principles, provides patients with a visual image of their swallowing muscles during eating. Often this assists patients in overcoming their swallowing dysfunction. In other cases patients benefit most from an operation to improve their swallowing function. In some patients the operation can be done in a minimally invasive fashion using a video camera, and in other cases the procedure is done purely through the mouth. Other patients benefit most from exposure of the esophagus through an incision in the left side of the neck. Regardless of the approach, Swallowing Center staff and surgeons in the Thoracic and Foregut division are dedicated to determining the cause of a patient's symptoms, and offering state-of-the-art therapy to correct the problem or palliate the symptom. |
