Swallowing disorders

Abstract

The three main symptoms of dysphagia are obstruction (impaired bolus transport), aspiration (inhalation of food particles or saliva), and globus sensation. Functional endoscopic evaluation of swallowing is the most important diagnostic tool in the practice of laryngology. For the treatment of most types of deglutition disorders, rehabilitation therapy is the basis of therapeutic management. Functional rehabilitation uses compensatory strategies to reduce the risk of aspiration. For patients with isolated cricopharyngeal achalasia without diverticulum, endoscopic cricopharyngeal myotomy or localized injection of botulinum toxin can be used. The treatment of Zenker's diverticulum has become an established domain of laser surgery, but open cricopharyngeus myotomy combined with diverticulectomy through a left-sided open approach is still an established surgical alternative. The most common procedure for controlling aspiration is tracheostomy and use of a cuffed tracheostomy tube. For severe aspiration, total laryngectomy,-closure of the larynx, or tracheoesophageal diversion may be needed. © Springer-Verlag Berlin Heidelberg 2010.