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Book Details
Abstract
Information on Dysphagia for Otolaryngolotists in this issue of Otolaryngologic Clinics: Emphasizes procedure-oriented evaluation and management; Discusses the importance of this subject in terms of medical and surgical risk; Heightens Otolaryngologists’ role in dysphagia patient care; Provides a set of recommendations to standardize the approach to these complicated patients; Describes aspects of dysphagia concisely, with prominent use of Tables and Figures. Among topics presented are: Etiology of Dysphagia; Dysphagia Screening and Assessment Instruments; The Modified Barium Swallow; Functional Endoscopic Evaluation of Swallowing; Esophageal Disease; Ancillary Testing in the Evaluation of Dysphagia; Malnutrition and Dehydration; Management of Cricopharyngeal Dysfunction; Zenker’s Diverticulum; Glottal Insufficiency with Aspiration Risk in Dysphagia; Global Laryngeal Dysfunction; Screening High-risk Groups, Pathway for Intervention, and more. Guest Editor Kenneth Altman of Mount Sinai, whose expertise, clinical work, and teaching is focused on laryngology, leads the group of expert physicians in this issue.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Dysphagia: Diagnosisand Management\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Otolaryngologic Clinics\rOf North America\r | xi | ||
| Preface\r | xiii | ||
| Fundamentals of Swallowing | A1 | ||
| The Evolution and Development of Human Swallowing | 923 | ||
| Key points | 923 | ||
| The aerodigestive tract among mammals | 924 | ||
| Unique development of the human aerodigestive tract | 927 | ||
| Embryonic Period | 927 | ||
| Fetal Period | 927 | ||
| Larynx-Nasopharynx Interlocking | 928 | ||
| Lower Respiratory Tract Concomitant Development | 928 | ||
| High Laryngeal Position | 928 | ||
| Descent of the Larynx | 930 | ||
| Evolution of the aerodigestive tract in the course of human evolution: choking to death along the way | 931 | ||
| References | 933 | ||
| The Normal Swallow | 937 | ||
| Key points | 937 | ||
| Introduction | 937 | ||
| Anatomy and contributing landmarks | 938 | ||
| Bones and Cartilages | 938 | ||
| Teeth | 938 | ||
| Spaces | 938 | ||
| Salivary Glands | 942 | ||
| Muscular control | 942 | ||
| Oral Preparatory Phase | 943 | ||
| Oral Transport Phase | 944 | ||
| Pharyngeal phase | 946 | ||
| Esophageal phase | 947 | ||
| Importance of airway protection | 949 | ||
| Neurophysiological control | 950 | ||
| Supratentorium | 951 | ||
| Infratentorium | 951 | ||
| Summary | 953 | ||
| References | 953 | ||
| Central Neural Circuits for Coordination of Swallowing, Breathing, and Coughing | 957 | ||
| Key points | 957 | ||
| Introduction | 958 | ||
| Neurophysiology of swallowing | 959 | ||
| Neurophysiology of cough and breathing | 959 | ||
| Control hypothesis for coordination of swallow, breathing, and coughing | 960 | ||
| Computational modeling of complex brainstem circuits for airway protection | 961 | ||
| Summary | 962 | ||
| References | 962 | ||
| Clinical Assessment | A3 | ||
| Causes of Dysphagia Among Different Age Groups | 965 | ||
| Key points | 965 | ||
| Introduction | 966 | ||
| Methods | 967 | ||
| Results | 967 | ||
| Prevalence of Dysphagia in the General Population | 967 | ||
| Causes of Dysphagia in Different Age Groups | 968 | ||
| Neurologic causes of dysphagia | 968 | ||
| Immunologic causes of dysphagia | 971 | ||
| Gastroesophageal causes of dysphagia | 973 | ||
| Congenital causes of dysphagia | 974 | ||
| Other causes | 974 | ||
| Oncologic | 974 | ||
| Head and Neck Cancer | 974 | ||
| Other Cancers | 974 | ||
| Discussion | 974 | ||
| Summary | 977 | ||
| References | 977 | ||
| Oropharyngeal Dysphagia | 989 | ||
| Key points | 989 | ||
| Introduction | 989 | ||
| Bedside screening | 990 | ||
| An Overview | 990 | ||
| Selection of Bedside Screening | 991 | ||
| Assessment | 997 | ||
| Gold Standards | 997 | ||
| Clinical Assessment | 997 | ||
| Patient Self-Evaluation | 1001 | ||
| Supplementary Methods | 1003 | ||
| Summary | 1004 | ||
| References | 1005 | ||
| The Modified Barium Swallow and the Functional Endoscopic Evaluation of Swallowing | 1009 | ||
| Key points | 1009 | ||
| Nature of the problem | 1009 | ||
| MBS procedure | 1010 | ||
| Technique Summary | 1010 | ||
| MBS Protocol Summary | 1010 | ||
| Equipment | 1012 | ||
| Radiation | 1013 | ||
| FEES procedure | 1013 | ||
| Technique Summary | 1013 | ||
| Assessment of Anatomy | 1013 | ||
| Topical Anesthesia | 1014 | ||
| Sensory Testing | 1014 | ||
| Secretion Level | 1014 | ||
| Use of Blue Food Coloring | 1015 | ||
| Swallow Function and Bolus Flow During FEES | 1015 | ||
| Comparison of the MBS versus the FEES | 1015 | ||
| Clinical Indicators | 1016 | ||
| Clinical Outcomes | 1017 | ||
| Aspiration rates | 1017 | ||
| Financial comparison | 1017 | ||
| Compensatory Strategies/Swallowing Interventions During the MBS and FEES | 1018 | ||
| Logistics of MBS Versus FEES | 1019 | ||
| Factors Affecting MBS or FEES Results | 1019 | ||
| Pediatric Considerations | 1020 | ||
| Summary | 1020 | ||
| References | 1021 | ||
| Normal Esophageal Physiology and Laryngopharyngeal Reflux | 1023 | ||
| Key points | 1023 | ||
| Introduction | 1023 | ||
| Anatomy | 1024 | ||
| Physiology | 1024 | ||
| Gastroesophageal reflux disease | 1028 | ||
| Laryngopharyngeal reflux | 1028 | ||
| Pathophysiology | 1028 | ||
| Diagnosis and Evaluation | 1030 | ||
| Management | 1036 | ||
| Summary | 1038 | ||
| References | 1038 | ||
| Esophageal Pathology | 1043 | ||
| Key points | 1043 | ||
| Introduction | 1043 | ||
| Cervical osteophytes | 1044 | ||
| Zenker diverticulum | 1045 | ||
| Cricopharyngeal bar | 1045 | ||
| Esophageal neoplasms | 1046 | ||
| Neurologic disorders | 1047 | ||
| Schatzki ring | 1047 | ||
| Esophageal diverticula | 1048 | ||
| GERD and esophageal stricture | 1048 | ||
| Achalasia | 1050 | ||
| Diffuse esophageal spasm | 1052 | ||
| Infectious esophagitis | 1052 | ||
| Eosinophilic esophagitis | 1052 | ||
| Rheumatologic diseases | 1055 | ||
| References | 1055 | ||
| Malnutrition, Dehydration, and Ancillary Feeding Options in Dysphagia Patients | 1059 | ||
| Key points | 1059 | ||
| Introduction | 1059 | ||
| Prevalence of dysphagia | 1060 | ||
| Malnutrition: macronutrient deficiencies | 1060 | ||
| Refeeding syndrome | 1061 | ||
| Macronutrient target intake | 1062 | ||
| Malnutrition: micronutrient deficiency | 1062 | ||
| Dehydration | 1063 | ||
| Dietary modification | 1063 | ||
| Nutritional supplements | 1063 | ||
| Nutritional support: enteral feeding | 1063 | ||
| Jejunostomy tubes | 1064 | ||
| Formula selection | 1065 | ||
| Feed schedule | 1066 | ||
| Nutrition support: parenteral nutrition | 1066 | ||
| Summary | 1067 | ||
| References | 1067 | ||
| Surgical and Other Interventions | A5 | ||
| Nonsurgical Treatment | 1073 | ||
| Key points | 1073 | ||
| Introduction | 1073 | ||
| Principles of care | 1074 | ||
| Introduction | 1074 | ||
| Assess Aspiration Risk and Deficit Focus | 1075 | ||
| Establishing a Treatment Schedule | 1075 | ||
| When to Reassess | 1076 | ||
| Oral Care | 1076 | ||
| Motor and sensory stimulation | 1076 | ||
| Electrical Stimulation | 1076 | ||
| Thermal-tactile Stimulation | 1077 | ||
| Exercise-based rehabilitative therapy | 1077 | ||
| Introduction | 1077 | ||
| Direct Swallow Maneuvers | 1078 | ||
| Indirect Swallow Exercises | 1079 | ||
| Lingual Strengthening | 1080 | ||
| Shaker Head Lift Exercise | 1080 | ||
| Expiratory Muscle Strength Training | 1081 | ||
| Prosthetic management | 1081 | ||
| Diet considerations | 1082 | ||
| Summary | 1082 | ||
| References | 1083 | ||
| Management of Cricopharyngeus Muscle Dysfunction | 1087 | ||
| Key points | 1087 | ||
| Introduction | 1087 | ||
| Evaluation of CPD | 1088 | ||
| Clinical Swallow Evaluation | 1088 | ||
| FEES | 1090 | ||
| Video-fluoroscopy | 1090 | ||
| Pharyngeal and UES Manometry | 1091 | ||
| Management of CPD | 1092 | ||
| Nonsurgical | 1092 | ||
| Dilation | 1093 | ||
| Botulinum Toxin Injection | 1093 | ||
| Myotomy | 1095 | ||
| Summary | 1097 | ||
| References | 1097 | ||
| Zenker Diverticulum | 1101 | ||
| Key points | 1101 | ||
| Introduction | 1101 | ||
| Anatomy | 1102 | ||
| Pathophysiology | 1102 | ||
| Symptoms | 1103 | ||
| Signs | 1103 | ||
| Open surgical treatment | 1103 | ||
| Open Myotomy or Diverticulectomy Technique | 1103 | ||
| Endoscopic treatment | 1106 | ||
| Endoscopic Diverticulectomy Technique | 1107 | ||
| Endoscopic CO2 Myotomy | 1109 | ||
| Treatment algorithm | 1110 | ||
| Summary | 1110 | ||
| References | 1110 | ||
| Glottal Insufficiency with Aspiration Risk in Dysphagia | 1113 | ||
| Key points | 1113 | ||
| Overview | 1113 | ||
| Cause and diagnosis | 1114 | ||
| Pathophysiology | 1114 | ||
| Management of dysphagia in glottal insufficiency | 1115 | ||
| Injection laryngloplasty | 1116 | ||
| Medialization thyroplasty with or without arytenoid repositioning | 1118 | ||
| Pharyngoplasty | 1120 | ||
| Cricopharyngeal myotomy | 1120 | ||
| Summary | 1120 | ||
| References | 1121 | ||
| Special Populations and Considerations | A7 | ||
| Special Groups | 1123 | ||
| Key points | 1123 | ||
| Introduction | 1123 | ||
| Radiation therapy | 1128 | ||
| Surgical intervention | 1129 | ||
| Glossectomy | 1129 | ||
| Mandibulectomy | 1132 | ||
| Total Laryngectomy | 1132 | ||
| Partial Laryngectomy | 1132 | ||
| Summary | 1133 | ||
| References | 1133 | ||
| Dysphagia in Stroke, Neurodegenerative Disease, and Advanced Dementia | 1137 | ||
| Key points | 1137 | ||
| Introduction | 1137 | ||
| Dysphagia in stroke | 1138 | ||
| Neurodegenerative disease | 1139 | ||
| Muscular Dystrophy | 1139 | ||
| Myasthenia Gravis | 1140 | ||
| Multiple Sclerosis | 1141 | ||
| Amyotrophic Lateral Sclerosis | 1141 | ||
| Parkinson's Disease | 1142 | ||
| Advanced dementia | 1142 | ||
| Sentinel indicators of decline with dysphagia and aspiration risk | 1143 | ||
| Screening and management protocol for high-risk patients | 1144 | ||
| Therapeutic interventions and neuroplasticity | 1145 | ||
| Treatment options for global laryngeal dysfunction | 1146 | ||
| Summary | 1146 | ||
| References | 1147 | ||
| Index | 1151 |