What is CSA (Comprehensive Swallow Assessment?)
Comprehensive Swallow Assessment (CSA) is a safe, medically non-invasive procedure for the sensory and motor assessment of the pharyngeal, laryngeal, and esophageal aspects of dysphagia while considering the oromotor inter-relationships. The safety and feasibility of CSA, which is also referred to as aerodigestoscopy (ADS), has been featured in a peer-reviewed article in The Journal of Clinical Medicine . SBA has safely completed over 20,000 procedures to date. To see a video tutorial demonstrating the procedure, click here.
Here is a short video introducing the procedure, which we are now referring to as “aerodigestoscopy” or ADS:
Our team were invited to present our work with ADS at The Cleveland Clinic in September 2025. If you would like to know more about the history of the procedure and details about its administration and clinical utility, Dr. Robert Arnold’s presentation is here:
It is not enough to know that a person has dysphagia and/or aspirates. It is imperative to know the “why” and the “how” so that treatment may be individualized for patient specific therapy interventions to expedite positive outcomes. SBA employs an endoscopically-based differential diagnostic algorithm for evaluating physiological disorders of the upper aerodigestive tract.
In addition to ruling in/out swallow disorders, it also affords the opportunity to rule in/out comorbidities with physiological disorders involving reflux disorders, cough disorders, and voice disorders. The complete CSA procedure includes:
- Comprehensive history & physical of the upper aerodigestive tract and its
overlapping/supporting body systems - Review of current medications and all available biomedical lab work
- Pre- and post-assessment vital signs
- Clinical Swallow Exam
- Endoscopic exam of velopharyngeal port
- Perceptual analysis of voice
- Acoustic analysis of voice
- Stroboscopic exam of the vocal folds
- FEES (Fiberoptic Endoscopic Evaluation of Swallowing)
- Reflux Finding Score
- Esophageal exam to identify physiological signs indicating the need for GI referral
- Gastric screening to determine normal gastric emptying and refer as needed for further work-up
- Comprehensive and detailed report of findings with treatment, management, diet and referral recommendations
- All performed by specialty-trained and highly competent endoscopists (SLPs)
*All of these are procedures based on sound clinical evidence and are bundled into one low-cost procedure typically with no minimum referrals required.