Symptoms & underlying cause

Anterior loss of bolus

Weak/incomplete lips closure, tongue thrust

Bolus poorly chewed

Weak jaw movement, decreased rotary movement (munching), poor dentition

Reside collection/oral stasis in lateral sulcus (pocketing)

Buccinator weakness

Posterior escape of bolus, residue on tongue, difficult a-p transit

Tongue weakness/incoordination, decreased sensation

Residue in pyriforms

Decreased laryngeal elevation, PES opening

Swallow delay/difficulty initating

Neurosensory deficit, decrease sensation in PW

Residue in vallecula

Poor TB retraction, incomplete epiglottic inversion

PPW residue

Weak pharyngeal constrictors

Penetration/aspiration before swallow

Swallow delay/neurosensory deficits, posterior escape of bolus

Penetration/aspiration during swallow

Incomplete epiglottic inversion, timing issue of airway closure, residue in pyriform/vallecula, backflow/reflux

Residue at the PES

Reduced PES opening d/t reduced laryngeal elevation