[The management of swallowing disorders through rehabilitation methods].
OBJECTIVE
Swallowing disorders are commonly encountered in ENT practice, and dysphagia may present a challenge with respect to diagnosis and management. This study aimed to examine patients with swallowing disorders.


METHODS
The study included 280 patients (153 males, 127 females; mean age 53 years; range 3-98 years) who presented with complaints of swallowing difficulties between October 2000 and June 2002. The patients were examined according to the protocol of our department for swallowing disorders, which involved a detailed history taking, a patient questionnaire on swallowing disorders, cervical auscultation, and modified barium swallow studies. When further investigation was needed, fiber-optic endoscopic swallow studies, ultrasonic evaluation of the tongue base, neck CT, and 24-hour double-probe pH monitoring were also undertaken.


RESULTS
A diagnosis of a swallowing disorder (premature spills, pulling in the vallecula and/or pyriform sinuses, penetration and/or aspiration, and delayed swallow reflex) was made in 164 patients. Dysphagia arose from a mechanical cause in 55%, and from a neurological cause in 32%. A multiphase rehabilitation program was initiated, which included positioning, adjusting bolus consistency, oral-motor range of motion exercises, use of palatal devices and swallowing techniques. Rehabilitation resulted in normal swallowing in 128 patients (78%).


CONCLUSIONS
Mechanical causes should also be sought in patients with swallowing disorders.
Gerek
Mustafa
M
Department of Otolaryngology, Gülhane Military Medical School, Ankara, Turkey. mgerek@gata.edu.tr
Ciyiltepe
Müzeyyen
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000534:rehabilitation*; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011795:Surveys and Questionnaires; D014421:Turkey / Q000453:epidemiology; D014463:Ultrasonography