Swallowing Disorders and Cricopharyngeal Dysfunction

Abstract

A functional swallow involves the neuromuscular coordination of ingestion and digestion of food.  Dysphagia is the term for abnormal swallowing, a discoordination of respiration, phonation, and digestion. Swallowing disorders can describe a simple abnormal sensation of swallow or a complex disorder leading to aspiration pneumonia. The most common cause of mortality and morbidity in dysphagia patients is aspiration pneumonia. Additional complications include malnutrition and dehydration. The prevalence of oropharyngeal dysphagia is up to 40% in adults over 65 and increases to 60% in institutionalized elderly. Oropharyngeal dysphagia is common after stroke, Parkinson’s disease, and other neurologic disorders. Patients in high-risk groups and patients with signs and symptoms of dysphagia should be diagnosed appropriately to determine underlying cause and aspiration risk. This chapter will focus on dysphagia due to pharyngeal phase disorders and their diagnosis and treatments.  This review contains 6 figures, 4 videos, 5 tables and 49 references. Key Words: dysphagia, swallowing, Zenker diverticulum, modified barium swallow, videofluoroscopic swallowing study, FEES, transnasal esophagoscopy, esophagram