Carnaby Videofluoroscopic Data Sheet

CARNABY VIDEOFLUOROSCOPIC DATA SHEET (C-VFE)
PATIENT:
CASE NO
DATE
ASSESSMENT NO:
0=NAD/WNL
1=MILD
2=MODERATE
3=SEVERE
4=COMPLETE
Oral preparation
1. THIN LQ 5cc
0 1
2
3
2. THIN LQ 10cc
0
1
2
3
3. NECTAR LQ 5cc
0
1
2
3
4
Oral Transit
Pharyngeal Initiation
Hyolaryngeal
elevation
Pharyngeal Function
C-P function
Aspiration
Oral preparation
4. NECTAR LQ 10cc
0 1
2
3
4
5. PUDDING 5cc
0
1
2
3
6. PUDDING 10cc
0
1
2
3
Oral Transit
Hyolaryngeal
elevation
Pharyngeal Function
C-P function
Aspiration
Oral preparation
7. CRACKER
0 1
2
3
8. CUP THIN LQ (optional)

0
1
2
3
4
9. STRAW THIN LQ-opt

0
1
2
3
4
Oral Transit
Hyolaryngeal
elevation
Pharyngeal Function
C-P function
Aspiration
MEDIAN DYSPHAGIA SCORE: ________
MEDIAN ASPIRATION SCORE: _______
Carnaby VFE Terms

Oral Preparation
Ability to control a bolus through lips and onto tongue. Ability to form and position
bolus. Operationally defined from entry past the lips to the hold position on the blade of
tongue.
Oral Transit
Ability to transport a bolus effectively through the oral cavity. Measured from the
moment the tongue achieves a horizontal position in the oral cavity upon initiation of
posterior bolus movement, to passage of the head of the bolus past the posterior aspect of
the ramus of mandible.
Appropriate triggering of the swallowing response to enable a coordinated swallow
sequence. Measured from moment the bolus passes the ramus of mandible until
excursion of the hyoid is initiated.
Hyo-laryngeal Excursion
Biomechanical motion of hyoid and laryngeal structures during swallow. Measured by
duration and range of maximal laryngeal and hyoid elevation and anterior excursion.
Pharyngeal Function
The management of the bolus through the pharynx. Measured by range of pharyngeal
wall movement/pharyngeal constriction, presence of post-swallow material in vallecullae
and/or piriform recesses, occurrence and frequency of penetration (entrance of materials
into laryngeal vestibule not below true vocal cords), and/or pharyngeal transit time
measured from arrival of bolus head at the vallecullae and pharyngeal response measured
from initiation of maximal hyoid excursion to hyoid rest.
PES Function
Management of bolus through PES including any dysfunction with observable
opening/closing characteristics or anatomical deviation e.g., C-P bar, Zenker's. Measured
by duration of U.E.S. opening, from first observable opening until closure.
Aspiration
Entrance of materials into the laryngeal vestibule below the level of the true vocal cords.
Measured by occurrence and frequency.
C-VFE Scoring Criteria

Ratin
g
0
1
2
4
Ratin
g
0
1
2
3
4
Dysphagia
Normal: No swallowing abnormality detected
Mild: Mild impairment in bolus control, delayed initiation of the swallow,
or reduced transport resulting in some residue of material without
laryngeal penetration
Moderate: Moderate impairment in bolus control, delayed initiation of the
swallow, or reduced transport, resulting in coating or stasis of
materials within the oral cavity and/or pharynx, slight laryngeal
penetration, or trace aspiration of thin liquid only
Severe: Severe impairment in bolus control, delayed initiation of swallow,
and reduced transport resulting in significant residue and
penetration (>10% of bolus) and/or aspiration of one or all
consistencies
Complete: No response to food stimulus; the initiation of a swallow
sequence is not obtained over several trials
Aspiration
Normal: No entry of contrast material through the true vocal cords
Mild: Trace of contrast materials through the true vocal cords
Moderate: Entry of small amount (estimated <10%) of bolus through the true
vocal cords
Severe: Entry of larger amount (estimated >10%) of bolus through the
true vocal cords
Complete: Frank aspiration of materials through the vocal cords without
observable reaction by the patient
Note: Attempt one bolus at each amount/type unless patient can manage more, then two may be
attempted. If two attempts are completed, score the first attempt for each material. If largely discrepant
between attempts, note this and discuss with site coordinator.

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CARNABY VIDEOFLUOROSCOPIC DATA SHEET (C-VFE)

8. CUP THIN LQ (optional)

9. STRAW THIN LQ-opt

MEDIAN DYSPHAGIA SCORE: ________

MEDIAN ASPIRATION SCORE: _______

Carnaby VFE Terms

C-VFE Scoring Criteria

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