Dysphagia as interdisciplinary diagnostic and therapeutic problem
Journal Title: Polski Przegląd Otorynolaryngologiczny - Year 2011, Vol 0, Issue 1
Abstract
The intricate mechanism of swallowing can be divided into three phases: oral, pharyngeal, and esophageal. Causes of disruptions in the swallowing process can be divided into superior (oropharyngeal) and inferior (esophageal). Neurlologic dysphagia may be caused by a disruption in different parts of the central nervous system (supranuclear level, level of motor and sensory nuclei taking part in swallowing process, peripherial nerves level and a pathology of muscle cells and spindles) or neuromuscular and muscular disorders. Neuromuscular disorders causes are: stroke, brain tumors, brain injury, bulbar and pseudobulbar paralysis, neurodegenerative diseases (amyotrophic lateral sclerosis, multiple sclerosis), tabes dorsalis, multisystem degenerations, Parkinson’s disease, delayed dyskineses, Huntington’s disease, myasthenia and myasthenic syndromes, myopathies and peripherial neuropathies. The correct diagnosis evaluation includes history taking, physical examination with palpation and consultations (laryngological, gastrological and neurological). Radiological esophagogram, videofluoroscopy, flexible endoscopic examination, ultrasound examination, manometry, electromyography, scintigraphy and 24 hour pH monitoring are main diagnostic procedures of dysphagia. Some of the reasons for the neurologic dysphagia may be treated by surgical and pharmacological methods. Neurlologic dysphagia rehabilitation is difficult, long-lasting and often falling far short of expected results. Primary it should include neurologic cause treatment if it is possible. According to WHO International Classification of Functioning and Health in 2001 non-invasive methods of dysphagia treatment may be divided into reconstitution, compensatory and adaptive techniques. The most popular reconstitution methods are thermal stimulation or tactilethermal application techniques. Dysphagia treatment by compensatory methods consists in various techniques of swallowing and posture changes application. Adaptive techniques include dietary changes avoiding o sustenances strengthening dysphagia and adequate dietary intake.
Authors and Affiliations
Jurek Olszewski, Hanna Zielińska-Bliźniewska, Piotr Pietkiewicz
Keywords
Related Articles
- EP ID EP50979
- DOI -
- Views 253
- Downloads 0
Ciało obce tkanek miękkich szyi – opis przypadku
Foreign bodies are common in otolaryngological practice. However, it happens rarely that the foreign body perforates the wall of the pharynx and mi grates extralum inally. A 52-year-old wom an was admitted to the ENT Dep...
Report of the Scientific and Training Conference CI Forum, Wrocław 29.11–01.12.2012
Congenital Cholesteatoma of Petrous Apex – case report and review of literature
Objective: Congenital cholesteatomas of the petrous apex are rare lesions that develop insidiously, which delays diagnosis and requires a high index of suspicion. A case report of supralabyrinthine congenital petrous bo...
Ostre rozlane zapalenie ucha zewnętrznego
Acute diffuse otitis extern a (OEAD) is a common conditi on especia lly in summer months. It is defined as generalized infl ammati on of the external canal skin, most often caused by bacterial infection (P. aeruginosa, S...
The role of bronchoscopy in the diagnosis of lower respiratory tract infections
Bronchoscopy was introduced into clinical practice over 100 years ago. Due to technological advances, diagnostic capabilities of current bronchoscopy are not limited to the trachea and proximal bronchi but also include t...