[Swallowing and swallowing disorders at the focus of otorhinolaryngology : From diagnosis to individualized treatment].

Abstract

Dysphagia refers to painless impairment of the transport of liquid or solid food from the oral cavity to the stomach. If pain accompanies swallowing, this is termed odynophagia, and discomfort when swallowing saliva suggests a globus pharyngis. Swallowing disorders can occur during any one or all phases of bolus transport. The causes are manifold, due to the involvement of central control areas within the brain as well as the peripheral nervous system. The diagnosis consists of a detailed case history as well as screening forms and questionnaires. In Germany, the gold standard diagnostic procedure is flexible (video-)endoscopic evaluation of swallowing. Videofluoroscopy and electrophysiological examinations complement the diagnosis. Therapeutic options comprise functional strategies and rehabilitative exercises. However, the most important task of otorhinolaryngologists, in addition to the primary surgical treatment of tumors in the area of the upper swallowing tract (taking into account the preservation of swallowing structures), is the assessment of posttreatment dysphagia with the option of individualized surgical measures to improve swallowing.