title: [Diagnosis and treatment of functional oropharyngeal dysphagia. Features of interest to the digestive surgeon].
abstract: Digestive surgeons should form part of the multidisciplinary team managing patients with oropharyngeal dysphagia. These patients can be diagnosed through clinical methods and complementary investigations such as videofluoroscopy and pharyngoesophageal manometry. These techniques also allow specific treatment to be selected. Up to one-third of patients with dysphagia suffer from malnutrition as a result of alterations in food bolus transport. Furthermore, up to two-thirds show alterations in swallowing safety (penetrations and aspirations, especially when swallowing liquids), as well as a high risk of respiratory infections and aspiration pneumonia. Increasing food bolus viscosity to 3500-4000 mPas (pudding viscosity) improves the effectiveness of swallowing and reduces the risk of aspirations. Botulinic toxin injection in the upper esophageal sphincter is indicated in patients with spasticity of neuromuscular origin. Cricopharyngeal myotomy is the basis of treatment for Zenker's diverticulum and is also indicated in patients with alterations in the upper esophageal sphincter and preserved oropharyngeal motor response.
authors.affiliation: Unidad de Exploraciones Funcionales Digestivas, Servicio de Cirugía, Hospital de Mataró, Universidad Autónoma de Barcelona, Carretera Cirera s/n, 08304 Mataró, Barcelona, España. pclave@teleline.es
authors.forename: Pere
authors.initials: P
authors.lastname: Clavé
authors.forename: Viridiana
authors.initials: V
authors.lastname: Arreola
authors.forename: Mercedes
authors.initials: M
authors.lastname: Velasco
authors.forename: Miquel
authors.initials: M
authors.lastname: Quer
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Castellví
authors.forename: Jordi
authors.initials: J
authors.lastname: Almirall
authors.forename: Pilar
authors.initials: P
authors.lastname: García Peris
authors.forename: Ricardo
authors.initials: R
authors.lastname: Carrau
mesh_terms: D003680:Deglutition Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation; D005502:Food; D005762:Gastroenterology; D005774:Gastrostomy; D006801:Humans; D044342:Malnutrition / Q000453:epidemiology; D008365:Manometry; D009960:Oropharynx / Q000503:physiopathology*; D010348:Patient Care Team; D011187:Posture; D012720:Severity of Illness Index; D014783:Viscosity