Case history: • Mr. D a 65-year-old man with PD for about 10 years comes to your outpatient office for re-evaluation. • Denies weight loss, denies pneumonia. • Video swallow study 5 years ago with mild dysphagia including poor oral control, delayed initiation, penetration of thin liquids but no aspiration. • Complains of: o Sense of aspiration ~10% of the time o Sense of pharyngeal residue with tough/chewy foods • Wife complains of dysarthria and dysphonia, but patient himself doesn’t notice. • EAT-10 score of 19/40, filled out just before your conversation with him. What exam would you perform first? A clinical evaluation, an instrumental evaluation (i.e., FEES or MBS), or defer to another provider for a different type of assessment?
