Funktionelle und elektrophysiologische Diagnostik bei Dysphagie

Thumfart, W. F.

doi:10.1007/978-3-642-84133-0_5

Cited by 5 publications

(2 citation statements)

References 177 publications

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“…Lediglich der M. cricopharyngeus zeigt einen Ruhetonus, der beim Einschlucken für 500 ms für die Boluspassage unterdrückt wird [93]. Eine komplette Parese des M. cricopharyngeus ist allerdings wegen der bilateralen Innervation über multiple Vagusfasern nur selten zu beobachten [109]. Eine komplette Parese des M. cricopharyngeus ist allerdings wegen der bilateralen Innervation über multiple Vagusfasern nur selten zu beobachten [109].…”

Section: Pharyngeale Sequenzcomputermanometrieunclassified

Schluckstörungen

Walther¹

1998

HNO

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Dysphagia is related to the impairment of food passage from the mouth to the stomach. Globus pharyngis implies the frequent and often painful sensation of a lump in the throat that usually does not interfere with swallowing and may even be relieved by food intake. The diagnosis is based upon a careful history, clinical examination, endoscopy, dynamic imaging (videofluoroscopy, cinematography, videosonography) and electrophysiologic procedures (including pharyngoesophageal manometry, electromyography and pH determinations). Structural lesions of the cervical spine such as diffuse idiopathic skeletal hyperostosis are rare causes of dysphagia. Dysphagia following anterior cervical fusion as well as globus and dysphonia due to dysfunction of the vertebral joints are more likely. Symptoms with swallowing fluids indicate a neurogenic origin. Dyscoordinated swallowing, nasal reflux, dysphonia or general weakness may also occur. Chronic aspiration with respiratory compromize is the main consequence in a variety of neurological disorders as well as in cases of postsurgical dysphagia. Relaxation of the upper esophageal sphincter indicates coordinated muscle movement between the pharynx and esophagus. Dysfunction of the pharyngoesophageal segment may lead to cricopharyngeal achalasia. A dyskinetic sphincter commonly represents an extrapharyngeal cause: i.e., disease associated with gastroesophageal reflux. Disorders of the esophageal phase of deglutition can produce retrosternal pain, heartburn, regurgitation and vomiting, as well as laryngeal and respiratory signs. Esophageal motility disorders include lower achalasia, tumors, peptic strictures, inflammatory diseases, drug-induced ulcers, rings and webs. Motility disorders present with aperistaltic, spontaneous contractions, diffuse esophagospasm, or a hypermotile esophagus. Gastroesophageal reflux with esophagitis must always be excluded, especially in patients with a globus sensation. The multiple features of the appearance of the symptoms of dysphagia and globus makes multidisciplinary approach necessary in order to establish a diagnosis and begin effective treatment.

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