In many degenerative neurogenic disorders, swallowing problems occur in different degrees of severity. It is difficult to say, however, which problems occur specifically with these conditions. There appears to be a large variability in the time between diagnosis and the occurrence of dysphagia. The incidence of dysphagia in patients with neurodegenerative diseases is estimated to be 40% (4, 5, 8).
The treatment of swallowing problems in degenerative conditions consists predominantly of advice on posture while eating and drinking and learning compensatory strategies. Exercises to strengthen particular muscles or muscle groups is usually contraindicated for these patient groups (3, 8).
The cause of dysphagia for patients undergoing surgical resection is evident. Tissue loss because of surgical excision, transection of muscles and nerves, and resulting scar and loss of sensation result in marked alteration in the functioning of tissues vital for normal swallowing. Swallowing rehabilitation is generally believed to be efficacious. Some studies suggest that postural techniques clearly result in decreased aspiration by 50% to 75% and that swallowing exercises may improve swallowing efficacy (17).
2. Ekberg, O., Hamdy, S., Woisard, V., Wuttge-Hannig, A., Ortega, P. (2002). Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia 17, 139-146.
3. Logemann, J. (1999). Evaluation and treatment of swallowing disorders. 2nd ed. Austin: Pro-Ed.
4. Rofes, L., Arreola, V., Akmirali, J., Cabré, M., Camins L., García-Peris, P., Speyer, R., Clavé, P. (2011). Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterology Research and Practice Volume 2011, Article ID 818979, 13 pages.
5. Schindler, A., Vincon, E., Grosso, E., Miletto, A.M., Rosa di, R., Schindler, O. (2008). Rehabilitative management of oroopharyngeal dysphagia in acute care settings: data from a large Italian teaching hospital. Dysphagia 23, 230–236.
8. Easterling E.A. and Robbins, E. (2008). Dementia and dysphagia. Geriatric Nursing 29, 275-285.
12. Dogget, D.L., Tappe, K.A., Mitchell, M.D., Chapell, R., Coates, V., Turkelson, C.M. (2001). Prevention of pneumonia in elderly stroke patients by systematic diagnosis and treatment of dysphagia: an evidence based comprehensive analysis of the literature. Dysphagia 16, 279-295.
13. Becker, R., Nieczaj, R., Egge, K., Moll, A., Meinhardt, M., Schulz, R-J. (2010). Functional dysphagia therapy and PEG treatment in a clinical geriatric setting. Dysphagia, DOI 10.1007/s00455-009-9270-8.
14. Elia, M., Stratton R.J., Holden, C., Meadows, N., Micklewright, A., Russel, C., Scott, D., Thomas, A., Shaffer, J., Wheatley, C., Woods, S.; Committee of the British Artificial Nutrition Survey (BANS). (2001). Home enteral tube feeding following cerebrovascular accident. Clinical Nutrition 20, 27-30.
15. Prosiegel, M., Heintze, M., Wagner-Sonntag, E., Hannig, C., Wuttge-Hannig, A., Yassouridis, A. (2002). Schluckstörungen bei neurologischen Patienten. Eine porspektive Studie zu Diagnostik, Störungsmustern, Therapie und Outcome. Nervenarzt 73, 364-370.
16. Nguyen, N.P., Frank, C., Moltz, C.C., Karlsson, U., Nguyen, P.D., Ward, H.W., Vos, P., Smith, H.J., Huang, S., Nguyen, L.M., Lemanski, C., Ludin, A., Sallah, S. (2009). Analysis of factors influencing dysphagia severity following treatment of head and neck cancer. Anticancer Research 29, 3299-3304.
17. Langmore, S.E., Terpenning, M., Schork, A., Chen, Y., Murray, J., Lopatin, D., Loesche, W. (1988) Predictors of aspiration pneumonia: how important is dysphagia? Dysphagia 13, 69-81.
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