Peter Belafsky, MD PhD The Otolaryngologist as • Professor and Director of the Voice and Swallowing Center, University of California-Davis Deglutologist • Vice Chair of Academic Affairs for the OTO-HNS Department • Internationally recognized as one of the Top Deglutologists in the Peter C. Belafsky, MD, PhD world [email protected] • Innovative approach resulting in numerous patents, “first in human” surgeries • Cross appointment with Veterinary School of Medicine • Lifetime Philadelphia Eagles fan – attended the Super Bowl and watched his team vanquish the Patriots Confused Patient Three Bobs Bob #1 Bob #2 Bob #3 Bob #1 H • 76yo solid & pill dysphagia • EAT10 - 25 EE • PILL5 - 13 • Community ENT (-) FEES • SLP (-) MBS Bob #2 • 72yo solid food dysphagia • EAT10 - 27 • PILL5 - 3 TIC • GI couldn’t pass EGD scope HH • GI couldn't pass Mano catheter Bob #3 • 36yo solid food dysphagia • EAT10 - 27 • RSI - 19 • GI EGD - Esophagitis • Placed on Prilosec 20mg SMART PILL Temperature 48hr pH Pressure Time Deglutology Palatal Valve Oral Cavity Pharynx Labial Valve UES Esophagus LES Pylorus Stomach Labial Valve Oral Cavity State-of-The-Art Diagnosis State-of-The-Art Labial Valve Oral Cavity Labial Valve Oral Cavity State-of-The-Art Treatment State-of-The-Art Treatment Oral Care Exercise/Rehabilitation Rx Drying Agents Botulinum Toxin Saliva System Labial Valve Oral Cavity Labial Valve Oral Cavity State-of-The-Art Treatment State-of-The-Art Treatment Frenulectomy Regenerative Medicine Injectables Facial Reanimation Palatal Valve Palatal Valve Oral Cavity Pharynx State-of-The-Art Diagnosis Labial Valve UES Esophagus LES Pylorus Stomach Palatal Valve Palatal Valve State-of-The-Art Diagnosis State-of-The-Art Diagnosis SSSSS K K K K UES Palatal Valve Palatal Valve State-of-The-Art Diagnosis State-of-The-Art Treatment SSSSS K K K K Palate Obturator Injection Pharyngoplasty Pharyngeal Flap Palatal Valve Palatal Valve State-of-The-Art Treatment State-of-The-Art Treatment Palatal Valve Pharynx Oral Cavity Pharynx State-of-The-Art Diagnosis Labial Valve UES Esophagus LES Pylorus Stomach Pharynx Pharynx State-of-The-Art Diagnosis State-of-The-Art Treatment Exercise Diverticulum Surgery Pharyngeal Reduction Pharynx Pharynx State-of-The-Art Treatment State-of-The-Art Treatment Epiglottis Surgery Positive Pressure Negative Pressure Pharynx Pharynx State-of-The-Art Treatment State-of-The-Art Treatment Palatal Valve UES Oral Cavity State-of-The-Art Diagnosis Pharynx Labial Valve UES Esophagus LES Pylorus Stomach UES UES State-of-The-Art Diagnosis State-of-The-Art Diagnosis UES UES State-of-The-Art Diagnosis State-of-The-Art Treatment Exercise Biofeesback UES UES State-of-The-Art Treatment State-of-The-Art Treatment CPM Botulinum Toxin Dilation Myotomy Myotomy UES State-of-The-Art Treatment Suspension SED Palatal Valve Esophagus Oral Cavity Pharynx Labial Valve UES Esophagus LES Pylorus Stomach Esophagus Esophagus State-of-The-Art Diagnosis State-of-The-Art Diagnosis Esophagus Esophagus State-of-The-Art Diagnosis State-of-The-Art Diagnosis Esophagus Esophagus State-of-The-Art Treatment State-of-The-Art Treatment Botulinum Toxin RFA Diet Rx REFLUX/Motility Esophagus Esophagus State-of-The-Art Treatment State-of-The-Art Treatment EMR CRYO RFA TIF Transoral incision-less funds Esophagus Esophagus State-of-The-Art Treatment State-of-The-Art Treatment FUNDO LINX POEMS Z-POEMS Palatal Valve Oral Cavity Pharynx Labial Valve UES Esophagus LES Pylorus Stomach Pylorus Stomach Dilation Botulinum toxin Myotomy Pacing Neuromodulation Achetylcholine AChEI Achetylcholine work at synapse to improve synaptic transmission DONEPEZIL pre post 57yo 6 yrs s/p CVA ECT Transcranial Magnetic Stimulation Maximum Current of 800 Milliamps Maximum Current of 2 Milliamps 65yo After Brainstem Stroke 65yo After Brainstem Stroke Post-ECT Pre-Therapy Chev didn’t stop at the cricoid..