Swallowing disorders

Abstract

Dysphagia represents the impairment of swallowing liquids and/or solid food and may occur due to an impairment of any part of the swallowing mechanism. Swallowing disorder has significant morbidity and mortality due to the possibility of malnutrition, loss of muscle mass, dehydration, aspiration, and aspirational pneumonia. Furthermore, it may significantly affect the quality of life and treatment of comorbidities. The purpose of this scoping review was to provide an overview of current guidelines and published literature (PubMed) to identify patients at risk for dysphagia eligible for further examinations, and treatment. Swallowing is a partly voluntary, and partly involuntary action. It can be divided into the oral, pharyngeal, and esophageal phases. Although swallowing disorders can occur in all age groups, they occur most often in the elderly, neurological patients, and patients with head and neck cancer. The diagnostic protocol for dysphagia includes a detailed history, physical examination of all structures involved in the act of swallowing, radiologic examinations (barium swallow test, videofluoroscopic swallow study, CT/MRI), endoscopic procedures (rigid or fiberoptic) and specific questionnaires to evaluate dietary intake, nutritional status and dysphagia-related quality of life. Therapeutic modalities include medications, correction of metabolic and nutritional deficits, bolus consistency modification, postural adjustments and swallow manoeuvers, specific exercise treatment, and surgery. Recently, an increasing number of studies have been published on sensory stimulation, which involves applying techniques like thermal and chemical stimulation, as well as neurostimulation in patients with dysphagia. Identifying persons at risk and treatment of dysphagia may prevent potentially fatal complications, reduce hospital length of stay and improve tolerance to the treatment of comorbidities.