An MBSS or VFSS may be ordered if a child is having problems swallowing or is suspected to be aspirating. During the procedure, the child swallows liquids and food that have been mixed with barium (a chalky substance that appears black on imaging). A series of live, moving X-ray images are taken while the child swallows. The barium/food mixture is visible on the X-ray images and the team can analyze the child’s swallow through the three phases: oral (mouth), pharyngeal (throat), and upper esophagus. An MBSS can help determine if aspiration/penetration is occurring and may help determine the cause of swallowing problems.

 If a laryngeal cleft is present and causing symptoms, laryngeal penetration or aspiration may be noticed during an MBSS. However, a mild laryngeal cleft is not always the primary cause of aspiration. Other possible causes include delayed development, related airway conditions, neuromuscular or genetic disorders, and more. It can be difficult to determine the cause of aspiration in some cases, especially with type 1 clefts.