Current Evaluation and Treatment of Patients with Swallowing Disorders

Abstract

To determine the varied causes of oropharyngeal dysphagia and their respective pathophysiology, a working understanding of the normal anatomy and function of the highly integrated mechanism of swallowing is outlined. This information is presented as the basis for a reasoned and detailed approach to the history, physical examination, and endoscopic evaluation of normal and altered oropharyngeal swallowing. The management of swallowing disorders depends on the nature and magnitude of the responsible clinical condition. Conservative and surgical approaches are discussed. These modalities and their indications are described in detail.

Flexible endoscopic and surgical management of Zenker's diverticulum

“…Resting UES pressure is distinctly asymmetrical; anterioposteriorly (55-60 mmHg) and transversely (30 mmHg) [21,22]. The zone of greatest pressure is located immediately above the inferior fibers of the CP.…”

Palliative Care in Amyotrophic Lateral Sclerosis, Parkinson's Disease, and Multiple Sclerosis

“…Surgical options include resection of the submandibular glands with ligation of the parotid ducts and transtympanic neurectomy, which produces denervation of some of the major salivary glands. [68][69][70] Redirection of salivary flow to the posterior pharynx is also an option, but is generally not helpful in patients with pharyngeal weakness. 69 Radiation to the submandibular and/or parotid glands effectively reduces salivary flow with xerostomia as an expected side effect.…”

Dysphagia Evaluation Practices of Speech and Language Therapists in Ireland: Clinical Assessment and Instrumental Examination Decision-Making

“…With regard to the management of individuals with a swallowing disorder (dysphagia), in particular, inappropriate management can place patients at high risk of aspiration, respiratory infections, choking/death, poor nutrition and weight loss, poor health, anxiety and stress within the family, hospital/admission or extended hospital stay, and reduced quality of life [1,3,4]. The goals of swallowing evaluations are to determine the presence, nature, and cause of the swallowing problem, current level of dysfunction, and nutritional status, and to develop strategies for stabilization and rehabilitation [5]. To achieve these goals it is clearly important that dysphagia evaluation and management practices within the SLT profession are consistent, clear, and well-defined.…”