Things that make you go hmmm…

I recently ran across this Modified Barium Swallow Study (MBSS) posted by, interestingly enough, the patient himself. Without benefit of a complete history and the original video, I will not say much about its interpretation, except that overall it appears fairly unremarkable. The posterior transfer of a small amount of liquid barium after the swallow is not uncommon, especially since it is followed in short order by a second swallow to clear (of course, it is impossible to tell from the video whether it was a spontaneous swallow or cued), and I have never had a patient with complaints that could be traced to this occurrence.

What interested me most were some of the patient’s comments: “I am interested in the dark area around the adams apple (its the half circle below my jaw that moves when I swallow). I was told this is dried up gunk from the pooling/leaking effect going on.…” I certainly hope that this was due to some sort of miscommunication, as the idea of a professional performing MBSS’s who is unable to recognize the HYOID BONE is frightening beyond words.