Kannit Pongpipatpaiboon

Dysphagia Evaluation and Treatment

This chapter discusses common dysphagia terminology. A common understanding of important terms relevant to dysphagia enables healthcare professionals to communicate clearly and rapidly. The basic knowledge of anatomical structures associated with swallowing is fundamental to understanding the whole swallow process including the evaluation and treatment of dysphagia. 1.1 Terminology of Dysphagia Swallowing is one of the most frequent activities of humans. Swallowing serves as a vital primary function to ensure nutrition and hydration and contributes to quality of life. Specific terminology is used among healthcare workers to communicate in a common language and is used every day for speaking and writing in medical charts. A description of the common terms used in the field of dysphagia is provided in Table 1.1. K. Pongpipatpaiboon • Y. Aoyagi • S. Shibata • H. Kagaya Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan e-mail: ning665@gmail.com; yyy@rc5.so-net.ne.jp; sshibata@fujita-hu.ac.jp; hkagaya2@fujita-hu.ac.jp Y. Inamoto (*) Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan e-mail: inamoto@fujita-hu.ac.jp K. Matsuo Department of Dentistry, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan e-mail: kmatsuo@fujita-hu.ac.jp

Overview of Structures and Essential Terms

This chapter discusses common dysphagia terminology. A common understanding of important terms relevant to dysphagia enables healthcare professionals to communicate clearly and rapidly. The basic knowledge of anatomical structures associated with swallowing is fundamental to understanding the whole swallow process including the evaluation and treatment of dysphagia.

Physiological Models of Swallowing

Swallowing is a complex activity in humans that involves coordinated activity of the mouth, pharynx, larynx, and esophagus. Thorough knowledge of these physiological processes is necessary to understand the complexity of swallowing and serves as an essential module for explaining the fundamental mechanisms that operate in swallowing activity. In addition, an understanding of the mechanism of swallowing allows us to formulate new questions that serve as the basis for experiments and detect specific problems that must be managed in the clinical setting. The swallowing sequence is divided into stages, each involving different food management behaviors. Two common models of drinking and eating are widely used.

Oral Hygiene Care

People with dysphagia are at a greater risk of poor oral hygiene and health. Dried secretion accumulated in oral cavity reduces oral sensitivity and promote bacterial growth. Aspiration of these pathogens can lead to life-threatening respiratory disorders and pulmonary infection. Oral care is therefore important issue from the perspective of preventing aspiration pneumonia and swallowing rehabilitation in dysphagic patients.

Other Swallowing Treatments

In addition to several methods of swallowing exercise widely used to improve swallowing function, the alternative treatment by using assistive device and surgical intervention are viable options to achieve the treatment outcome, for safety and for improved quality of life. The common devices and surgical techniques commonly used in our practice are described in this chapter.

Dysphagia from the Viewpoint of Rehabilitation Medicine

Dysphagia is a common problem in medical situations. Many disease processes are associated with a high incidence of dysphagia. Individuals with dysphagia may have multiple problems and need assessment and treatment that requires the input of multiple health professional specialists. Good team approach will increase the efficacy of dysphagia treatment.

Clinical Evaluation of Dysphagia

Clinical evaluation, both instrumental and noninstrumental, plays an important role in the swallowing assessment of the patients with dysphagia. The gathered information from thorough evaluation contributes the presence of dysphagia, dysphagia severity level, rehabilitation planning, and both the problem and the potential solution. The dysphagia screening, clinical and instrumental assessment, and new perspectives in advanced swallowing assessment will be described in this chapter.