Pharyngeal Disorders: Diagnosis with Combined Videofluoroscopy and Manometry (Videfluoromanometry)
Authors: S. Cappabianca, L. Brunese, A. Reginelli, M.G. Pezzullo, G. Gatta, R Grassi and A. Rotondo
Abstract: Swallowing is an essential biological function, and any alteration can determine severe consequences, such as malnutrition, dehydration, aspiration pneumonia or airway obstruction [1-2]. Swallowing disorders have a variety of causes: neurological disease, neoplasia of the oral cavity, the pharynx and/or the larynx, connective tissue disease, trauma, infection or iatrogenic illness [3-4]. Because dysphagia covers a wide range of symptoms, from a vague or subtle sensation of abnormal swallowing in an ambulatory alert patient, to a severely handicapped bedridden patient who does not seem to be able to swallow at all, a complete evaluation of the swallowing mechanism should be carried out [5-8]. Oral and pharyngeal phase dysfunctions are often due to central nervous system disorders of pyramidal and extrapyramidal pathways and peripheral nervous system motor impairment. Neurogenic dysphagia may result from cortical (generally bilateral ) lesions of the pyramidal tracts, movement disorders (for example Parkinson‘s disease), cerebellar disorders, brain stem lesions, lesion of the cranial nerves, their neuromuscular junctions or of the oral, pharyngeal or esophageal striated muscles. [9-11]. The number of swallowing impaired persons is substantial, particularly among the elderly. It is believed that 30% to 40% of nursing home residents have some form of swallowing impairment common in the elderly. These individuals are particularly prone to episodes of choking during swallowing, a sign that the swallowing mechanism is abnormal [12-14].