Pharynx: Benign and malignant conditions

Abstract

A large variety of peripheral neuropathies, myopathies, and central nervous system abnormalities cause dysphagia (Bucholz 1987). Dysphagia can result from any abnormality involving the peripheral or cranial sensory or motor nerves, the swallowing center in the brainstem, or the supratentorial regions of the brain controlling tongue function, cognitive function involved in swallowing or muscular movement of the bolus to the lips. In our practice, the most common neurogenic causes of dysphagia are acute cerebrovascular accidents, small vessel ischemic disease, Parkinson's disease, multiple sclerosis, myasthenia gravis, muscular dystrophy, and dermatomyositis. Patients who have undergone cranial, neck, and thoracic operations may have direct intracranial, central cranial nerve or recurrent laryngeal nerve damage. Some postoperative patients have postoperative cerebrovascular damage. Any patient with a tracheostomy tube may have dysphagia due to impaired elevation of the pharynx/larynx with poor timing between the oral and pharyngeal phase and/or diminished epiglottic tilt.