Dysphagia: Diagnosis and Treatment

604 Pages·2012·23.419 MB·English

by  Olle Ekberg, Göran Nylander (auth.), Olle Ekberg (eds.)

Medical Radiology
Diagnostic Imaging
Series Editors
Maximilian F. Reiser
Hedvig Hricak
Michael Knauth
Editorial Board
Andy Adam, London
Fred Avni, Brussels
Richard L. Baron, Chicago
Carlo Bartolozzi, Pisa
George S. Bisset, Durham
A. Mark Davies, Birmingham
William P. Dillon, San Francisco
D. David Dershaw, New York
Sam Sanjiv Gambhir, Stanford
Nicolas Grenier, Bordeaux
Gertraud Heinz-Peer, Vienna
Robert Hermans, Leuven
Hans-Ulrich Kauczor, Heidelberg
Theresa McLoud, Boston
Konstantin Nikolaou, Munich
Caroline Reinhold, Montreal
Donald Resnick, San Diego
Rüdiger Schulz-Wendtland, Erlangen
Stephen Solomon, New York
Richard D. White, Columbus
For furthervolumes:
http://www.springer.com/series/4354
Olle Ekberg
Editor
Dysphagia
Diagnosis and Treatment
Foreword by
Maximilian F. Reiser
123
Editor
OlleEkberg
Department of ClinicalSciences
Skåne UniversityHospital
LundUniversity
Malmö
Sweden
ISSN 0942-5373
ISBN 978-3-642-17886-3 ISBN 978-3-642-17887-0 (eBook)
DOI 10.1007/978-3-642-17887-0
SpringerHeidelbergNewYorkDordrechtLondon
LibraryofCongressControlNumber:2012945741
(cid:2)Springer-VerlagBerlinHeidelberg2012
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To my wife Guje
with romance, felicity and affection
Olle Ekberg
Foreword
Dysphagia is a symptom of many and diverse diseases causing serious dero-
gation of the quality of life. Diagnosis and treatment of dysphagia requires
knowledgeandexperienceofspecialistsfrommultipledisciplines,suchasENT
specialists, neurologists, gastroenterologists and various other disciplines. For
the radiologists involved in interdisciplinary teams, which are devoted to the
diagnosis and treatment of dysphagia, knowledge of the anatomy and physi-
ology is fundamental. Familiarity with the clinical background and available
treatment options is mandatory.
Thecurriculumofmostpostgraduateinstitutionsdoesnotincludeprofound
training in specialized examinations of dysphagia. Professor Ekberg and the
other authors of this book have great merits by providing comprehensive
information covering anatomy, physiology, pathophysiology, pathology and
clinical background. This book includes chapters on gastroesophageal reflux
disease, globus and dysphagia, pediatric aspects on dysphagia, dysphagia in
systemic disease, the geriatric pharynx and esophagus, voice and dysphagia as
well as psychiatric aspects of dysphagia. The functional and cross-sectional
imaging methods for the assessment of swallowing and its disorders are
described in detail.
After the first edition in 2004 this second edition incorporates all newly
discovered knowledge in this rapidly advancing field.
OnbehalfoftheserieseditorsofMedicalRadiology—DiagnosticImagingI
wouldliketoextendoursincerethankstoProf.Ekbergandhisco-workersfor
this extraordinary work. We are sure that it will be a great help for those
interested indysphagia and treatment of patientssuffering from this symptom.
In addition to radiologists, specialists of various other medical disciplines
can obtain most valuable information.
Munich Maximilian F. Reiser
vii
Preface
In preparing this volume, my aim has been to organize and set down, as con-
cisely as possible, what may be considered the basic facts concerning the
diagnosis and treatment of dysphagia. A principal focus is how to analyze the
symptom of dysphagia, which is of the utmost importance and forms the basis
for selection of any further steps in evaluation. In the clinical work-up, radi-
ology is crucial. This was the topic of the book Radiology of the Pharynx and
Esophagus, published by Springer in 2004. The continued rapid advances in
dysphagologyintheinterveningperiodhavepromptedmetoreviseandexpand
that book. Seventeen chapters have been updated and refreshed, while 19 are
completely new and place dysphagia in an even broader and deeper context.
Particularlytheconsequenceslikemalnutritionanddehydrationarethoroughly
described.
The current book therefore contains detailed information on anatomy,
physiology, pathophysiology, pathology and clinical background as well as
differentaspectsofnutritionandmalnutrition.Itbridgesthegapbetweenbasic
anatomy and physiology and the clinical management of patients with
dysphagia.
Theauthorsoftheindividualchaptersareexpertsintheirfieldsandmostof
them are engaged in hands-on practical work with patients.
The skilful assistance provided by Ms. Eva Prahl has been invaluable in
bringingtogetherallthelooseendstocreatewhatIhopewillbeawell-received
volume.
Ialsowishtothankallthecontributorstothevolumeand,particularly,Ms.
Corinna Schaefer and Ms. Daniela Brandt of the publisher’s staff. Their
enthusiasm and skilful guidance have been invaluable.
Olle Ekberg
ix
Contents
Part I Anatomy and Physiology
Anatomy and Physiology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Olle Ekberg and Göran Nylander
Saliva and the Control of Its Secretion. . . . . . . . . . . . . . . . . . . . . . . . . 19
Jörgen Ekström, Nina Khosravani, Massimo Castagnola, and Irene Messana
Feeding and Respiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Olle Ekberg, Anna I. Hårdemark Cedborg, Katarina Bodén,
Hanne Witt Hedström, Richard Kuylenstierna, Lars I. Eriksson,
and Eva Sundman
Oral and Pharyngeal Function and Dysfunction. . . . . . . . . . . . . . . . . . 55
Olle Ekberg
Part II Clinical Evaluation
Evaluation of Symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Doris-Maria Denk-Linnert
Neurology of Swallowing and Dysphagia . . . . . . . . . . . . . . . . . . . . . . . 83
Mario Prosiegel
Gastroesophageal Reflux Disease, Globus, and Dysphagia. . . . . . . . . . . 107
Jacqui Allen and Peter C. Belafsky
Pediatric Aspect of Dysphagia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Pascale Fichaux Bourin, Michèle Puech, and Virginie Woisard
Dysphagia in Systemic Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Thomas Mandl and Olle Ekberg
The Geriatric Pharynx and Esophagus. . . . . . . . . . . . . . . . . . . . . . . . . 165
Olle Ekberg
xi
xii Contents
Voice and Dysphagia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Daniele Farneti
Psychiatric Aspects of Dysphagia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Margareta Bülow
Part III Imaging and other Examination Techniques
The Clinical and Radiological Approach to Dysphagia . . . . . . . . . . . . . 201
Peter Pokieser and Martina Scharitzer
Imaging Techniques and Some Principles
of Interpretation (Including Radiation Physics) . . . . . . . . . . . . . . . . . . 237
Olle Ekberg
Pharyngeal Morphology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
Stephen E. Rubesin
Morphology of the Esophagus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
Marc S. Levine and Arastoo Vossough
The Pediatric Esophagus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Jane E. Benson
Pharyngeal Manometry. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315
Rolf Olsson
Esophageal Manometry and Gastroesophageal Reflux Monitoring. . . . . 323
Karin Aksglæde, Per Thommesen, and Peter Funch-Jensen
Impedance Planimetry. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329
Johannes Lenglinger
Radiologic Evaluation of Esophageal Function. . . . . . . . . . . . . . . . . . . 339
Wolfgang Schima, Edith Eisenhuber, and Christiane Kulinna-Cosentini
Neuroimaging in Patients with Dysphagia . . . . . . . . . . . . . . . . . . . . . . 359
Kasim Abul-Kasim
Cross-Sectional Imaging of the Oesophagus Using
CT and PET/Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369
Ahmed Ba-Ssalamah, Barbara J. Fueger, and Wolfgang Schima
Endoscopy of the Pharynx and Esophagus. . . . . . . . . . . . . . . . . . . . . . 391
Doris-Maria Denk-Linnert and Rainer Schöfl
Contents xiii
Part IV Treatment
The Therapeutic Swallowing Study . . . . . . . . . . . . . . . . . . . . . . . . . . . 411
Margareta Bülow and Bonnie Martin-Harris
Surgical Aspects of Pharyngeal Dysfunction,
Dysphagia, and Aspiration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425
Hans F. Mahieu and Martijn P. Kos
The Post-Operative Pharynx and Larynx. . . . . . . . . . . . . . . . . . . . . . . 445
Anita Wuttge-Hannig and Christian Hannig
Dysphagia Evaluation and Treatment After Head and Neck
Surgery and/or Chemo-radiotherapy
for Head and Neck Malignancies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 459
Antonio Schindler, Francesco Mozzanica, and Filippo Barbiera
Behavioural Treatment of Oropharyngeal Dysphagia:
Bolus Modification and Management, Sensory and Motor
Behavioural Techniques, Postural Adjustments,
and Swallow Manoeuvres . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 477
Renée Speyer
Rheological Aspects of Swallowing and Dysphagia . . . . . . . . . . . . . . . . 493
Edmundo Brito-de la Fuente, Olle Ekberg, and Críspulo Gallegos
The Dietitian’s Role in Diagnosis and Treatment of Dysphagia. . . . . . . 507
S. Burton, A. Laverty, and M. Macleod
Direct and Indirect Therapy: Neurostimulation for the Treatment
of Dysphagia After Stroke. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 519
Satish Mistry, Emilia Michou, Dipesh H. Vasant, and Shaheen Hamdy
Intervention on the Esophagus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 539
Jason D. Conway, David J. Ott, and Michael Y. Chen
The Importance of Enteral Nutrition. . . . . . . . . . . . . . . . . . . . . . . . . . 555
Christina Stene and Bengt Jeppsson
Part V Complications
Complications of Oropharyngeal Dysphagia: Malnutrition
and Aspiration Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 575
Silvia Carrión, Eric Verin, Pere Clavé, and Alessandro Laviano
Dehydration in Dysphagia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 601
Zeno Stanga, Samuel Hannes Baldinger, and Pere Clavé
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 611