title: Reconstructive and rehabilitating methods in patients with dysphagia and nutritional disturbances.
abstract: As diverse as the causes of oropharyngeal dysphagia can be, as broad is the range of potential therapeutical approaches. In the past two decades, methods of plastic-reconstructive surgery, in particular microsurgically revascularised tissue transfer and minimally invasive, endoscopic techniques of every hue have substantially added to the portfolio of reconstructive surgery available for rehabilitating deglutition. Numerically, reconstructing the pharyngolaryngeal tract following resection of squamous-cell carcinomas in the oral cavity, the pharynx and the larynx has been gaining ground, as has functional deglutitive therapy performed to treat posttherapeutical sequelae. Dysphagia and malnutrition are closely interrelated. Every third patient hospitalised in Germany suffers from malnutrition; ENT tumour patients are not excluded. For patients presenting with advancing malnutrition, the mortality, the morbidity and the individual complication rate have all been observed to increase; also a longer duration of stay in hospital has been noted and a lesser individual toleration of treatment, diminished immunocompetence, impaired general physical and psychical condition and, thus, a less favourable prognosis on the whole. Therefore, in oncological patients, the dietotherapy will have to assume a key role in supportive treatment. It is just for patients, who are expected to go through a long process of deglutitive rehabilitation, that enteral nutrition through percutaneous endoscopically controlled gastrostomy (PEG) performed at an early stage can provide useful and efficient support to the therapeutic efforts. Nutrition and oncology are mutually influencing fields where, sooner or later, a change in paradigms will have to take place, i.e. gradually switching from therapy to prevention. While cancer causes malnutrition, feasible changes in feeding and nutrition-associated habits, including habitual drinking and smoking, might lower the incidence of cancer worldwide by 30 to 40% (American Institute of Cancer Research 1999).Esse oportet, ut vivas, non vivere ut edas. / Thou shouldst eat to live, not live to eat.Cicero 106 - 43 B.C.
authors.affiliation: Otto-von-Guericke-Universität Magdeburg, Klinik für Hals-, Nasen- and Ohrenheilkunde, Magdeburg, Deutschland.
authors.forename: Christiane
authors.initials: C
authors.lastname: Motsch
references.citation: Laryngorhinootologie. 1989 Nov;68(11):595-601
references.pmid: 2604814
references.citation: Surg Endosc. 2003 Jun;17(6):990-6
references.pmid: 12806523
references.citation: HNO. 2001 Feb;49(2):143-56; quiz 156-7
references.pmid: 11270198
references.citation: HNO. 2001 Nov;49(11):930-2
references.pmid: 11759247
references.citation: Otolaryngol Head Neck Surg. 1990 Nov;103(5 ( Pt 1)):837-40
references.pmid: 2126112
references.citation: Z Gastroenterol. 1996 Jun;34(6):404-8
references.pmid: 8767832
references.citation: J Clin Gastroenterol. 2003 Oct;37(4):307-11
references.pmid: 14506388
references.citation: Australas Radiol. 1995 Nov;39(4):399-400
references.pmid: 8561719
references.citation: HNO. 1993 Aug;41(8):380-4
references.pmid: 8407379
references.citation: Eur J Clin Nutr. 2003 Jul;57(7):876-8
references.pmid: 12821887
references.citation: Eur J Pediatr Surg. 2003 Oct;13(5):289-93
references.pmid: 14618516
references.citation: Laryngorhinootologie. 2001 Dec;80(12):714-8
references.pmid: 11793267
references.citation: J Voice. 2002 Mar;16(1):136-42
references.pmid: 12002881
references.citation: Chirurg. 2002 Mar;73(3):217-22
references.pmid: 11963494
references.citation: Arch Pediatr. 2004 Jan;11(1):13-7
references.pmid: 14700754
references.citation: Laryngoscope. 2001 Jun;111(6):1063-7
references.pmid: 11404622
references.citation: Laryngoscope. 2003 Apr;113(4):628-34
references.pmid: 12671418
references.citation: Med Klin (Munich). 2002 Sep 15;97(9):558-63
references.pmid: 12371086
references.citation: Head Neck. 1993 Jan-Feb;15(1):70-3
references.pmid: 8416862
references.citation: Z Gastroenterol. 2000 Mar;38(3):229-34
references.pmid: 10768245
references.citation: Eur J Pediatr Surg. 1998 Apr;8(2):71-4
references.pmid: 9617603
references.citation: N Engl J Med. 2001 May 31;344(22):1676-9
references.pmid: 11386266
references.citation: Pediatr Surg Int. 2004 Mar;20(3):207-10
references.pmid: 15083331
references.citation: Acta Radiol. 2004 Apr;45(2):130-5
references.pmid: 15191094
references.citation: Dysphagia. 2002 Winter;17(1):34-9
references.pmid: 11820385
references.citation: Z Gerontol Geriatr. 1999 Jul;32 Suppl 1:I69-74
references.pmid: 10441806
references.citation: Head Neck. 1999 Jul;21(4):363-5
references.pmid: 10376757
references.citation: AJR Am J Roentgenol. 2002 Sep;179(3):735-9
references.pmid: 12185055
references.citation: Ther Umsch. 2003 Apr;60(4):219-23
references.pmid: 12731432
references.citation: Endoscopy. 1995 Jan;27(1):124-7
references.pmid: 7601024
references.citation: Klin Padiatr. 2001 Nov-Dec;213(6):329-31
references.pmid: 11713711
references.citation: Gastrointest Endosc. 1996 May;43(5):483-9
references.pmid: 8726763
references.citation: Acta Otorhinolaryngol Belg. 1994;48(2):207-15
references.pmid: 8209683
references.citation: Gastrointest Endosc. 2003 Jul;58(1):116-20
references.pmid: 12838237
references.citation: HNO. 1996 Jun;44(6):339-53
references.pmid: 8767132
references.citation: JPEN J Parenter Enteral Nutr. 2004 May-Jun;28(3):180-3
references.pmid: 15141412
references.citation: Dtsch Med Wochenschr. 1997 Oct 31;122(44):1337-42
references.pmid: 9410705
references.citation: J Gastroenterol Hepatol. 2002 Oct;17(10):1125-8
references.pmid: 12201877
references.citation: J Gastroenterol. 2003;38(11):1077-80
references.pmid: 14673726
references.citation: Ann Otol Rhinol Laryngol. 1999 Sep;108(9):864-8
references.pmid: 10527277
references.citation: Laryngorhinootologie. 1999 Sep;78(9):508-11
references.pmid: 10535068
references.citation: Endoscopy. 2003 May;35(5):462
references.pmid: 12701026
references.citation: Arch Otorhinolaryngol Suppl. 1990;1:107-56
references.pmid: 2191641
references.citation: Z Gastroenterol. 2000 Dec;38(12):933-8
references.pmid: 11194881
references.citation: Head Neck. 2000 Dec;22(8):826-30
references.pmid: 11084645
references.citation: Hosp Med. 2004 Apr;65(4):246-7
references.pmid: 15127685
references.citation: Am J Surg. 2004 Jan;187(1):58-63
references.pmid: 14706587
references.citation: Plast Reconstr Surg. 2002 Nov;110(6):1408-13; discussion 1414-6
references.pmid: 12409757
references.citation: J Laparoendosc Adv Surg Tech A. 2003 Feb;13(1):69-72
references.pmid: 12676027
references.citation: Am Surg. 2002 Jun;68(6):590-3
references.pmid: 12079145
references.citation: Dysphagia. 1999 Summer;14(3):157-61
references.pmid: 10341113
references.citation: Radiology. 1993 Jun;187(3):661-5
references.pmid: 7684528
references.citation: Head Neck. 2003 Apr;25(4):261-6
references.pmid: 12658729
references.citation: Ann Plast Surg. 2000 Aug;45(2):181-6
references.pmid: 10949348
references.citation: Eur Arch Otorhinolaryngol. 2004 Feb;261(2):68-70
references.pmid: 12883813
references.citation: Head Neck. 2000 Mar;22(2):156-63
references.pmid: 10679903
references.citation: Chirurg. 1994 Feb;65(2):139-41
references.pmid: 8162817
references.citation: BMC Cancer. 2002 May 10;2:13
references.pmid: 12003643
references.citation: Endoscopy. 1989 Nov;21(6):295
references.pmid: 2612434
references.citation: HNO. 2002 Sep;50(9):829-35
references.pmid: 12425137
references.citation: Zhonghua Yi Xue Za Zhi (Taipei). 2001 May;64(5):315-9
references.pmid: 11499343
references.citation: Laryngorhinootologie. 2001 Aug;80(8):449-57
references.pmid: 11552424
references.citation: Fortschr Med Orig. 2001;119(1):41-4
references.pmid: 11935657
references.citation: Br J Radiol. 2002 Apr;75(892):371-7
references.pmid: 12000697
references.citation: J Exp Clin Cancer Res. 2002 Dec;21(4):503-7
references.pmid: 12636096
references.citation: Laryngorhinootologie. 2003 May;82(5):358-63
references.pmid: 12800082
references.citation: Dtsch Med Wochenschr. 1999 Mar 26;124(12):370-1
references.pmid: 10214372
references.citation: HNO. 2002 Mar;50(3):201-8
references.pmid: 11975074
references.citation: Best Pract Res Clin Gastroenterol. 2004 Feb;18(1):3-17
references.pmid: 15123081
references.citation: Infusionsther Transfusionsmed. 1993 Apr;20(1-2):26-37
references.pmid: 8504239
references.citation: Arch Otolaryngol Head Neck Surg. 2003 Jan;129(1):44-9
references.pmid: 12525193
references.citation: Ann Chir. 1998;52(10):978-82
references.pmid: 9951097
references.citation: Surg Endosc. 2003 Feb;17(2):351
references.pmid: 12436228
references.citation: Hosp Med. 1998 Sep;59(9):693-7
references.pmid: 9829076
references.citation: Laryngoscope. 2003 Jun;113(6):957-65
references.pmid: 12782805
references.citation: Laryngoscope. 2004 Mar;114(3):519-27
references.pmid: 15091228
references.citation: Endoscopy. 2003 Aug;35(8):S9-13
references.pmid: 12929047
references.citation: Hosp Med. 2000 Jan;61(1):33-6
references.pmid: 10735151
references.citation: Surg Endosc. 2003 Oct;17(10):1678
references.pmid: 12874695
references.citation: HNO. 2001 May;49(5):392-5
references.pmid: 11405149
references.citation: Gastrointest Endosc. 2001 Aug;54(2):145-53
references.pmid: 11474382
references.citation: HNO. 2001 Apr;49(4):276-82
references.pmid: 11382108
references.citation: Chirurg. 2001 Oct;72(10):1131-6
references.pmid: 11715615
references.citation: Clin Radiol. 2002 Nov;57(11):1028-33
references.pmid: 12409115
references.citation: Z Gastroenterol. 1999 Sep;37(9):789-93
references.pmid: 10522365
references.citation: Am J Med. 2003 Aug 18;115 Suppl 3A:172S-174S
references.pmid: 12928097
references.citation: Endoscopy. 1984 Nov;16(6):219-22
references.pmid: 6439549
references.citation: Dysphagia. 2003 Spring;18(2):78-84
references.pmid: 12825900
references.citation: HNO. 2001 Sep;49(9):724-31
references.pmid: 11593773
references.citation: Rofo. 2000 Apr;172(4):374-80
references.pmid: 10961223
references.citation: Zentralbl Chir. 1999;124(6):489-94
references.pmid: 10436505
references.citation: Dtsch Med Wochenschr. 2001 Jun 15;126(24):722-4
references.pmid: 11446029
references.citation: Aliment Pharmacol Ther. 2003 Jul 15;18(2):209-15
references.pmid: 12869081
references.citation: Arch Otolaryngol Head Neck Surg. 2002 Dec;128(12):1388-95
references.pmid: 12479726
references.citation: Dig Liver Dis. 2002 Apr;34(4):298-301
references.pmid: 12038815
references.citation: Am J Gastroenterol. 2002 May;97(5):1273-4
references.pmid: 12014751
references.citation: J Laryngol Otol. 1993 Oct;107(10):946-9
references.pmid: 8263399
references.citation: HNO. 1995 Oct;43(10):605-10
references.pmid: 7499166
references.citation: Chirurg. 2002 Nov;73(11):1132-5
references.pmid: 12430066
references.citation: Cancer. 2001 May 1;91(9):1785-90
references.pmid: 11335904
references.citation: HNO. 1991 Jun;39(6):203-7
references.pmid: 1917583
references.citation: Bildgebung. 1993 Sep;60(3):176-82
references.pmid: 8251742
references.citation: Ann Plast Surg. 2003 May;50(5):450-5
references.pmid: 12792531
references.citation: Surg Endosc. 2002 Mar;16(3):538-9
references.pmid: 11928047
references.citation: Chirurg. 2000 Dec;71(12):1513-6
references.pmid: 11195074
references.citation: Br J Oral Maxillofac Surg. 2004 Feb;42(1):46-8
references.pmid: 14706300
references.citation: Radiologe. 2001 Jun;41(6):473-7
references.pmid: 11458779
references.citation: Gastrointest Endosc. 2001 Jul;54(1):140
references.pmid: 11427871
references.citation: Dtsch Med Wochenschr. 1995 Dec 22;120(51-52):1768-72
references.pmid: 8549261
references.citation: Laryngoscope. 2001 Oct;111(10):1847-52
references.pmid: 11801956
references.citation: J Laryngol Otol. 2002 Oct;116(10):826-30
references.pmid: 12437839
references.citation: Acta Chir Plast. 2002;44(4):120-3
references.pmid: 12661925
references.citation: Laryngoscope. 1988 Jan;98(1):71-8
references.pmid: 3336265
references.citation: HNO. 1999 May;47(5):479-84
references.pmid: 10412657
references.citation: HNO. 1991 Jun;39(6):212-7
references.pmid: 1917585
references.citation: Laryngorhinootologie. 1998 Jan;77(1):7-17
references.pmid: 9522307
references.citation: HNO. 1995 May;43(5):323-30
references.pmid: 7607919
references.citation: Laryngorhinootologie. 1999 May;78(5):259-62
references.pmid: 10412135
references.citation: Head Neck. 2000 Aug;22(5):463-8
references.pmid: 10897105
references.citation: Support Care Cancer. 1995 Sep;3(5):313-6
references.pmid: 8520878
references.citation: Clin Commun Disord. 1993 Fall;3(4):11-20
references.pmid: 8111360
references.citation: Dtsch Med Wochenschr. 1997 Sep 19;122(38):1149-53
references.pmid: 9378026
references.citation: Dis Esophagus. 2001;14(2):120-3
references.pmid: 11553221
references.citation: Laryngorhinootologie. 1989 Dec;68(12):675-7
references.pmid: 2514698
references.citation: J Voice. 2001 Jun;15(2):295-304
references.pmid: 11411484
references.citation: Z Gastroenterol. 2000 Mar;38(3):271-3
references.pmid: 10768251
references.citation: Ann Otol Rhinol Laryngol. 2003 Mar;112(3):202-5
references.pmid: 12656409
references.citation: Rofo. 1993 Nov;159(5):450-5
references.pmid: 8219139
references.citation: JPEN J Parenter Enteral Nutr. 2003 May-Jun;27(3):216-9
references.pmid: 12757116
references.citation: HNO. 2004 Apr;52(4):311-9
references.pmid: 15029425
references.citation: Postgrad Med J. 2002 Apr;78(918):198-204
references.pmid: 11930022
references.citation: Laryngoscope. 2003 Jan;113(1):63-7
references.pmid: 12514384
references.citation: Laryngorhinootologie. 1995 Jul;74(7):437-43
references.pmid: 7669136
references.citation: Arch Otolaryngol Head Neck Surg. 2003 Jan;129(1):36-43
references.pmid: 12525192
references.citation: Ir Med J. 2003 Oct;96(9):265-7
references.pmid: 14753579
references.citation: Z Gastroenterol. 1989 Jun;27 Suppl 2:65-8
references.pmid: 2514512
references.citation: J Clin Gastroenterol. 2003 Apr;36(4):297-302
references.pmid: 12642734
references.citation: BMJ. 2000 Mar 25;320(7238):870; author reply 871-2
references.pmid: 10777315
references.citation: Laryngoscope. 2004 Feb;114(2):208-11
references.pmid: 14755191
references.citation: Gastrointest Endosc. 2001 Oct;54(4):543-4
references.pmid: 11577333
references.citation: Head Neck. 2003 Aug;25(8):681-94
references.pmid: 12884352
references.citation: Z Gastroenterol. 1993 Oct;31(10):612-3
references.pmid: 7504855
references.citation: J Hosp Infect. 2002 Apr;50(4):312-5
references.pmid: 12014907
references.citation: Clin Otolaryngol Allied Sci. 2001 Dec;26(6):447-51
references.pmid: 11843921
references.citation: Acta Chir Belg. 2003 Feb;103(1):95-7
references.pmid: 12658885
references.citation: Eur J Cardiothorac Surg. 2001 Apr;19(4):406-10
references.pmid: 11306304
references.citation: Chirurg. 1993 Jan;64(1):71-2
references.pmid: 8436055
references.citation: Am J Gastroenterol. 2001 Mar;96(3):936-7
references.pmid: 11280597
references.citation: Br J Oral Maxillofac Surg. 2002 Aug;40(4):330-3
references.pmid: 12175835
references.citation: Laryngorhinootologie. 2002 Mar;81(3):233-42
references.pmid: 11967777
references.citation: Ann Otol Rhinol Laryngol. 2003 Jul;112(7):583-93
references.pmid: 12903677
references.citation: Ann Chir. 1997;51(6):611-6
references.pmid: 9406458
references.citation: Endoscopy. 2004 May;36(5):472
references.pmid: 15100974
references.citation: Dis Esophagus. 2002;15(2):180-5
references.pmid: 12220429
references.citation: J Voice. 2003 Mar;17(1):88-95
references.pmid: 12705822
references.citation: Nurs Stand. 2004 Jan 28-Feb 3;18(20):41-3
references.pmid: 14976704
references.citation: Laryngorhinootologie. 1990 Jul;69(7):360-8
references.pmid: 2244950
references.citation: Nutrition. 2003 Oct;19(10):905-6
references.pmid: 14559330
references.citation: Ann Otol Rhinol Laryngol. 2000 Aug;109(8 Pt 1):767-75
references.pmid: 10961811
references.citation: HNO. 1996 Nov;44(11):616-23
references.pmid: 9064295
references.citation: Laryngorhinootologie. 2001 May;80(5):269-74
references.pmid: 11417250
references.citation: Plast Reconstr Surg. 1999 Feb;103(2):442-7; discussion 448-9
references.pmid: 9950529
references.citation: Support Care Cancer. 2000 Sep;8(5):410-3
references.pmid: 10975691
references.citation: Am J Surg. 1999 Oct;178(4):316-22
references.pmid: 10587191
references.citation: HNO. 1991 Jun;39(6):208-11
references.pmid: 1917584
references.citation: Arch Surg. 2001 Oct;136(10):1164-70
references.pmid: 11585510
references.citation: Zentralbl Chir. 1997;122(5):344-8
references.pmid: 9334095
references.citation: Int J Radiat Oncol Biol Phys. 2002 May 1;53(1):23-8
references.pmid: 12007937
references.citation: Laryngorhinootologie. 1997 Nov;76(11):704-8
references.pmid: 9517983
references.citation: Laryngorhinootologie. 2001 Aug;80(8):470-7
references.pmid: 11552427
references.citation: Endoscopy. 2003 Mar;35(3):246-7; author reply 248
references.pmid: 12584646
references.citation: Head Neck. 2001 Sep;23(9):733-8
references.pmid: 11505482
references.citation: Dtsch Med Wochenschr. 1996 Mar 22;121(12):359-63
references.pmid: 8815013
references.citation: Otolaryngol Head Neck Surg. 2001 Jan;124(1):58-67
references.pmid: 11228455
references.citation: Chirurg. 1997 Apr;68(4):389-94
references.pmid: 9206634
references.citation: Ann R Coll Surg Engl. 1998 Mar;80(2):115-8
references.pmid: 9623376
references.citation: Bildgebung. 1992 Mar;59 Suppl 1:4-6
references.pmid: 1376631
references.citation: Chirurg. 2000 Dec;71(12):1493-9
references.pmid: 11195070
references.citation: Arch Otolaryngol Head Neck Surg. 2001 Aug;127(8):975-9
references.pmid: 11493209
references.citation: Jpn J Thorac Cardiovasc Surg. 2002 Jan;50(1):1-5
references.pmid: 11855093
references.citation: Radiologe. 1995 Oct;35(10):741-6
references.pmid: 7501801
references.citation: HNO. 1998 Nov;46(11):925-31
references.pmid: 9864677
references.citation: J Clin Gastroenterol. 2001 Sep;33(3):215-7
references.pmid: 11500610
references.citation: Ann R Coll Surg Engl. 2001 Jul;83(4):295
references.pmid: 11518387
references.citation: Surg Endosc. 2003 Jun;17(6):891-5
references.pmid: 12618935
references.citation: Am J Gastroenterol. 2001 Jun;96(6):1791-6
references.pmid: 11419831
references.citation: Gastrointest Endosc. 2000 Feb;51(2):152-6
references.pmid: 10650256
references.citation: Am J Gastroenterol. 2000 Nov;95(11):3288-91
references.pmid: 11095357
references.citation: Am Surg. 2000 Oct;66(10):956-8; discussion 958-9
references.pmid: 11261624
references.citation: BMJ. 2000 Mar 25;320(7238):871; author reply 871-2
references.pmid: 10777317
references.citation: Ann Thorac Surg. 1996 Oct;62(4):963-7
references.pmid: 8823073
references.citation: Wien Klin Wochenschr. 2003 Feb 28;115(3-4):115-20
references.pmid: 12674688
references.citation: Plast Reconstr Surg. 2004 Feb;113(2):499-507
references.pmid: 14758209
references.citation: Radiology. 1998 May;207(2):513-8
references.pmid: 9577503
references.citation: Laryngoscope. 2003 Sep;113(9):1473-6
references.pmid: 12972917
references.citation: Arch Facial Plast Surg. 1999 Apr-Jun;1(2):130-2
references.pmid: 10937092
references.citation: Endoscopy. 2002 Feb;34(2):139-45
references.pmid: 11822009
references.citation: Endoscopy. 2001 Oct;33(10):843-8
references.pmid: 11571679
references.citation: Chirurg. 1999 Aug;70(8):868-75
references.pmid: 10460280
references.citation: Clin Nutr. 2003 Aug;22(4):415-21
references.pmid: 12880610
references.citation: Ir Med J. 2001 Oct;94(9):270-2
references.pmid: 11820518
references.citation: Dis Esophagus. 2002;15(3):210-3
references.pmid: 12444992
references.citation: J Laryngol Otol. 1993 Aug;107(8):723-5
references.pmid: 8409726
references.citation: Dtsch Med Wochenschr. 2001 Feb 16;126(7):191-2
references.pmid: 11236530
references.citation: Am J Gastroenterol. 2000 Aug;95(8):1920-5
references.pmid: 10950036
references.citation: Dysphagia. 1987;2(2):65-71
references.pmid: 3507297
references.citation: Acta Otolaryngol. 1997 Sep;117(5):769-74
references.pmid: 9349879
references.citation: Int J Oral Maxillofac Surg. 2003 Dec;32(6):593-9
references.pmid: 14636608
references.citation: Radiology. 1986 Feb;158(2):543-5
references.pmid: 2934763
references.citation: Oral Oncol. 2000 Sep;36(5):471-3
references.pmid: 10964056
references.citation: Curr Opin Otolaryngol Head Neck Surg. 2003 Jun;11(3):160-5
references.pmid: 12923356
references.citation: Surg Laparosc Endosc Percutan Tech. 2001 Dec;11(6):375-8
references.pmid: 11822863
references.citation: Endoscopy. 1989 Jan;21(1):45-6
references.pmid: 2492932
references.citation: Z Gastroenterol. 2002 Jul;40(7):517-20
references.pmid: 12122600
references.citation: Cardiovasc Intervent Radiol. 2004 Jan-Feb;27(1):3-8
references.pmid: 15109220
references.citation: Chir Ital. 1999 Mar-Apr;51(2):99-108
references.pmid: 10514924
references.citation: Hepatogastroenterology. 2000 May-Jun;47(33):724-7
references.pmid: 10919019
references.citation: JBR-BTR. 2004 Jan-Feb;87(1):17-20
references.pmid: 15055328
references.citation: Br J Oral Maxillofac Surg. 2002 Apr;40(2):125-30
references.pmid: 12180203
references.citation: Otolaryngol Head Neck Surg. 2003 Oct;129(4):305-10
references.pmid: 14574281
references.citation: Head Neck. 2004 Apr;26(4):365-72
references.pmid: 15054740
references.citation: Cardiovasc Intervent Radiol. 2002 Nov-Dec;25(6):467-71
references.pmid: 12357317
references.citation: Br J Plast Surg. 2000 Jan;53(1):12-6
references.pmid: 10657443
references.citation: Radiology. 1993 Jun;187(3):667-71
references.pmid: 8497612
references.citation: Surg Endosc. 2003 Jan;17(1):129-33
references.pmid: 12370775
references.citation: BMJ. 2000 Mar 25;320(7238):870-1; author reply 871-2
references.pmid: 10777316
references.citation: Laryngorhinootologie. 2002 Jan;81(1):17-21
references.pmid: 11845398
references.citation: HNO. 2002 Dec;50(12):1068-74
references.pmid: 12474129
references.citation: Head Neck. 2001 Dec;23(12):1080-3
references.pmid: 11774395
references.citation: Laryngorhinootologie. 1999 Sep;78(9):516-20
references.pmid: 10535070
references.citation: Arch Otolaryngol Head Neck Surg. 2000 Mar;126(3):384-9
references.pmid: 10722013
references.citation: Ann Thorac Surg. 2001 Jun;71(6):1797-801; discussion 1801-2
references.pmid: 11426750
references.citation: J Thorac Cardiovasc Surg. 2001 Apr;121(4):642-8
references.pmid: 11279403
references.citation: Eur Arch Otorhinolaryngol. 2003 Apr;260(4):198-206
references.pmid: 12709803
references.citation: Int Surg. 2003 Apr-Jun;88(2):64-7
references.pmid: 12872895
references.citation: Aliment Pharmacol Ther. 2003 Nov 1;18(9):947-8
references.pmid: 14616159
references.citation: Z Gastroenterol. 1991 Dec;29(12):655-8
references.pmid: 1771948
references.citation: Dysphagia. 1997 Fall;12(4):188-93
references.pmid: 9294937
references.citation: Laryngoscope. 2000 Jul;110(7):1082-5
references.pmid: 10892674
references.citation: Postgrad Med J. 1997 Jul;73(861):430-2
references.pmid: 9338033
references.citation: Dtsch Med Wochenschr. 1991 Jan 11;116(2):77
references.pmid: 1985814
references.citation: Z Gastroenterol. 2002 Apr;40 Suppl 1:S8-S14
references.pmid: 11930283
references.citation: Z Gastroenterol. 1998 May;36(5):475-8
references.pmid: 9654710
references.citation: Clin Rehabil. 2003 Mar;17(2):228-9
references.pmid: 12625666
references.citation: JPEN J Parenter Enteral Nutr. 2001 Sep-Oct;25(5):282-5
references.pmid: 11531220
references.citation: Clin Plast Surg. 2001 Apr;28(2):349-60
references.pmid: 11400828
references.citation: Laryngorhinootologie. 2000 Jan;79(1):39-42
references.pmid: 10689680
references.citation: Laryngorhinootologie. 2001 Nov;80(11):632-4
references.pmid: 11702268
references.citation: Am Surg. 1997 Jun;63(6):481-6
references.pmid: 9168757
references.citation: Laryngorhinootologie. 2002 Oct;81(10):712-7
references.pmid: 12397521
references.citation: Fortschr Med Orig. 2002 Dec 5;120(4):143-6
references.pmid: 12613272
references.citation: Am J Med. 2003 Aug 18;115 Suppl 3A:175S-178S
references.pmid: 12928098
references.citation: Schweiz Med Wochenschr. 1994 Apr 16;124(15):655-9
references.pmid: 8191271
references.citation: Praxis (Bern 1994). 2002 May 15;91(20):892-900
references.pmid: 12071092
references.citation: Internist (Berl). 2004 Jul;45(7):756-68
references.pmid: 15241505
references.citation: Laryngoscope. 2001 May;111(5):747-58
references.pmid: 11359151
references.citation: Dysphagia. 1995 Fall;10(4):255-8
references.pmid: 7493506
references.citation: J Postgrad Med. 2003 Oct-Dec;49(4):325-7
references.pmid: 14699231
references.citation: J Oral Maxillofac Surg. 2003 Nov;61(11):1279-84
references.pmid: 14613083
references.citation: Z Ernahrungswiss. 1979 Mar;18(1):62-70
references.pmid: 442710
references.citation: Gastrointest Endosc. 2002 Jan;55(1):110-5
references.pmid: 11756930
references.citation: Ann Thorac Surg. 1993 Sep;56(3):573-6
references.pmid: 8379739