The goal of the second edition continues to be a singlevolume presentation of deglutology with focus on the symptom dysphagia: its causes and management. The target readers are the large and growing healthcare professionals who deal with patients with swallowing problems
Medical Radiology · Diagnostic Imaging Series Editors: H.-U Kauczor · P.M Parizel · W.C.G Peh Olle Ekberg Editor Dysphagia Diagnosis and Treatment Second Edition Medical Radiology Diagnostic Imaging Series Editors Hans-Ulrich Kauczor Paul M Parizel Wilfred C G Peh For further volumes: http://www.springer.com/series/4354 Olle Ekberg Editor Dysphagia Diagnosis and Treatment Second Edition Editor Olle Ekberg Department of Translational Medicine Lund University Department of Medical Imaging and Physiology Skåne University Hospital Malmö, Sweden ISSN 0942-5373 ISSN 2197-4187 (electronic) Medical Radiology ISBN 978-3-319-68571-7 ISBN 978-3-319-68572-4 (eBook) https://doi.org/10.1007/978-3-319-68572-4 Library of Congress Control Number: 2018947533 © Springer International Publishing AG, part of Springer Nature 2012, 2019 This work is subject to copyright All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed The use of general descriptive names, registered names, trademarks, service marks, etc in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations Printed on acid-free paper This Springer imprint is published by the registered company Springer International Publishing AG part of Springer Nature The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Preface to the Second Edition The goal of the second edition continues to be a single-volume presentation of deglutology with focus on the symptom dysphagia: its causes and management The target readers are the large and growing healthcare professionals who deal with patients with swallowing problems The continued rapid advances in diagnostics have prompted extensive revision of many chapters as well as inclusion of new chapters Of pivotal importance for the understanding of dysphagia is the clinical history, carefully obtained and used to triage the instrumental evaluation and specific treatments The clinical history is crucial for understanding the result of the examinations A new chapter on high-resolution manometry clarifies how it is performed and its potential as a problem solver Abundant and diverse treatment options are now available Each is described by world leading experts As care of the dysphagic patient may be fraught with ethical and moral issues, a closing chapter on this theme has been added Crucial for the compilation of new material for this second edition is the prosperous activities in the European Society for Swallowing Disorders (ESSD) A rapidly growing organization led by Professor Pere Clavé who with skills and enthusiasm is guiding and fostering us to become better deglutologists To achieve this he has by his side Jane Lewis, executive officer of ESSD, who with grace and patience has developed our society It has been a pleasure working together with the authors of this book Please enjoy! Malmö, Sweden Olle Ekberg v Contents Part I: Anatomy and Physiology natomy and Physiology A Olle Ekberg and Göran Nylander aliva and the Control of Its Secretion 21 S Jörgen Ekström, Nina Khosravani, Massimo Castagnola, and Irene Messana eeding and Respiration 59 F Olle Ekberg, Anna I Hårdemark Cedborg, Katarina Bodén, Hanne Witt Hedström, Richard Kuylenstierna, Lars I Eriksson, and Eva Sundman ral and Pharyngeal Function and Dysfunction 65 O Olle Ekberg Part II: Clinical Evaluation valuation of Symptoms 83 E Doris-Maria Denk-Linnert eurology of Swallowing and Dysphagia 95 N Mario Prosiegel astroesophageal Reflux Disease, Globus, and Dysphagia 123 G Jacqui Allen and Peter C Belafsky I rritable Bowel Syndrome and Dysphagia 149 Bodil Ohlsson ICU-Related Dysphagia 157 Rainer Dziewas and Tobias Warnecke ysphagia in Amyotrophic Lateral Sclerosis 165 D Lauren C Tabor and Emily K Plowman ysphagia in Parkinson’s Disease 175 D Emilia Michou, Christopher Kobylecki, and Shaheen Hamdy ropharyngeal Dysphagia and Dementia 199 O Omar Ortega and María Carmen Espinosa vii viii ediatric Aspect of Dysphagia 213 P Pascale Fichaux Bourin, Michèle Puech, and Virginie Woisard ysphagia in Systemic Disease 237 D Thomas Mandl and Olle Ekberg he Geriatric Pharynx and Esophagus 247 T Olle Ekberg oice and Dysphagia 257 V Daniele Farneti sychiatric Aspects of Dysphagia 275 P M Bülow Part III: Imaging and Other Examination Techniques he Clinical and Radiological Approach to Dysphagia 285 T Peter Pokieser and Martina Scharitzer I maging Techniques and Some Principles of Interpretation (Including Radiation Physics) 317 Olle Ekberg orphologic and Kinematic Analysis of Swallowing M Using Multislice CT 333 Yoko Inamoto and Eiichi Saitoh Pharyngeal Morphology 351 Stephen E Rubesin orphology of the Esophagus 385 M Marc S Levine he Pediatric Esophagus 411 T Jane E Benson igh-Resolution Manometry of the Pharynx H and Esophagus 425 Nathalie Rommel Impedance Planimetry 439 Johannes Lenglinger sophagus: Radiologic Evaluation of Esophageal E Function 451 Wolfgang Schima, Martina Scharitzer, Edith Eisenhuber, and Christiane Kulinna-Cosentini adiology of the Lower Esophageal Sphincter and Stomach R in Patients with Swallowing Disorders 477 Martina Scharitzer and Peter Pokieser euroimaging in Patients with Dysphagia 497 N Kasim Abul-Kasim Contents Contents ix ross-Sectional Imaging of the Oesophagus Using CT C and PET/Techniques 507 Ahmed Ba-Ssalamah ndoscopy of the Pharynx and Oesophagus 531 E Doris-Maria Denk-Linnert and Rainer Schöfl I n Vitro Models for Simulating Swallowing 549 Waqas Muhammad Qazi and Mats Stading Part IV: Treatment he Therapeutic Swallowing Study 565 T M Bülow urgical Aspects of Pharyngeal Dysfunction, Dysphagia, S and Aspiration 581 Hans F Mahieu and Martijn P Kos urgery in Benign Oesophageal Disease 603 S Jan Johansson he Postoperative Pharynx and Larynx 633 T Anita Wuttge-Hannig and Christian Hannig ysphagia Evaluation and Treatment After Head and Neck Surgery D and/or Chemoradiotherapy of Head and Neck Malignancy 649 Antonio Schindler, Francesco Mozzanica, and Filippo Barbiera ehavioral Treatment of Oropharyngeal Dysphagia 669 B Renée Speyer heological Aspects of Swallowing and Dysphagia: Shear R and Elongational Flows 687 Edmundo Brito-de la Fuente, Mihaela Turcanu, Olle Ekberg, and Críspulo Gallegos he Dietitian’s Role in Diagnosis and Treatment of Dysphagia 717 T M Macleod and S O’Shea irect and Indirect Therapy: Neurostimulation for the Treatment D of Dysphagia After Stroke 731 Emilia Michou, Ayodele Sasegbon, and Shaheen Hamdy ensory Stimulation Treatments for Oropharyngeal Dysphagia 763 S Daniel Alvarez-Berdugo, Noemí Tomsen, and Pere Clavé harmacologic Treatment of Esophageal Dysmotility 781 P Caryn Easterling, Venelin Kounev, and Reza Shaker he Importance of Enteral Nutrition 793 T Christina Stene and Bengt Jeppsson ral Care in the Dysphagic Patient 813 O Jose Nart and Carlos Parra x Part V: Complications omplications of Oropharyngeal Dysphagia: Malnutrition C and Aspiration Pneumonia 823 Silvia Carrión, Alicia Costa, Omar Ortega, Eric Verin, Pere Clavé, and Alessandro Laviano ehydration in Dysphagia 859 D Zeno Stanga and Emilie Aubry ocial and Psychologic Impact of Dysphagia 873 S Nicole Pizzorni thical Issues and Dysphagia 887 E David G Smithard Index 905 Contents Contributors Kasim Abul-Kasim Faculty of Medicine, Diagnostic Centre for Imaging and Functional Medicine, Skåne University Hospital, Malmö, Sweden Lund University, Malmö, Sweden Jacqui Allen Department of Otolaryngology, North Shore Hospital, Auckland, New Zealand Daniel Alvarez-Berdugo Gastrointestinal Tract Motility Laboratory, CIBERehd-CSdM, Hospital de Mataró, Mataró, Spain Emilie Aubry Division of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, University Hospital, Bern, Switzerland Filippo Barbiera Unità Operativa di Radiologia “Domenico Noto”, Azienda Ospedali Civili Riuniti “Giovanni Paolo II”, Sciacca, Italy Ahmed Ba-Ssalamah Department of Radiology, Medical University of Vienna, Vienna, Austria Peter C Belafsky Center for Voice and Swallowing, University of California, Davis, Sacramento, CA, USA Jane E Benson Russell H Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Katarina Bodén Department of Diagnostic Radiology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden Pascale Fichaux Bourin Unité de la Voix et de la Déglutition, Department of Ear‚ Nose and Throat, CHU de Toulouse, Hôpital Larrey, Toulouse Cedex 9, France M Bülow VO BoF, Skane University Hospital, Malmö, Malmư, Sweden Silvia Carrión Unidad de Exploraciones Funcionales Digestivas, Hospital de Mataró, Universitat Autịnoma de Barcelona, Barcelona, Spain Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas (Ciberehd), Instituto de Salud Carlos III, Madrid, Spain Massimo Castagnola Istituto di Biochimica e Biochimica Clinica, Facoltà di Medicina, Università Cattolica and Istituto per la Chimica del Riconoscimento Molecolare, CNR, Rome, Italy xi Index 910 Dysphagia (cont.) pathophysiology, 130–131, 815–818 patient, clinical symptoms of, 85–86 patient’s symptoms comparison, 312–313 patterns, 662 pediatric esophagus, 412 pharynx, 317, 318 post-stroke clinical management, 728–729 neurophysiological substrates, 726–727 psychological domains, 867 psychosocial assessment ICF, 871–874 screening tools, 874 SWAL-QOL, 871 quality of life, 889–890 radiation physics/safety, 323–324 during radiologic examination, 312 barium swallow examination, 315–316 biphasic examination, 315 conventional (digital) exposure technique, 318 digitally stored image, 317 elderly patient with, 314 fluoroscopic intensifier, 316 frontal projection, 320 frozen fluoroscopic image, 318, 319 high-density barium contrast medium, 316 identify misdirected swallowing, 322 iodine swallow examination, 316–317 modern digital radiologic equipment, 316 projections/positioning, 319 single-contrast examination, 321 46-year-old woman with, 313 repetitive oral suction, 324 right to life, 883 social and financial burden, 886–887 social and psychologic impact social participation, 865–866 solid bolus examination, 320, 322–323 stroke, 495–497 structural/neurogenic impairments, 724 surgical treatment anterior cervical osteophytes, 584–585 anterior–lateral surgical extrapharyngeal approach, 585 fibrosis and strictures, of pharynx, 587–591 meningoceles, 585 retropharyngeal tumor mass, 586–587 type neurofibromatosis, 585 swallowing apparatus, 312 and swallowing complaints, 81 swallowing symptoms, 312 systemic disease Behỗet disease, 237238 berylliosis, 238239 epidermolysis bullosa dystrophica, 237 inflammatory myopathies, 239, 240 lichen planus, 237 pemphigus and pemphigoid, 237 PSS, 233–234 rheumatoid arthritis, 234–235 sarcoidosis, 238 scleroderma, 235, 236 SLE, 236 treatment, 125 behavioral therapy, 125–126 laryngeal procedures, 128–129 medical therapy, 126 novel procedures, 129–130 UES, 127–128 ultrasonography, 324 videoradiography, 324–325 Dyspraxia of feeding, 218–219 Dystonia, 103 Dystussia airway compromise, physiology of, 164–165 airway safety, impairments in, 165 assessing swallow function, 163–164 bolus inefficiency, physiology of, 165 neuropathologic underpinnings of, 162–163 E Eagle syndrome, 108 Early enteral feeding, 787 Ear, nose, and throat (ENT) surgery, 625 functional alterations, 633 morphological and functional abnormalities, 629 morphologic alterations, 634 type and severity of aspiration, 633 Eating, 25 Eating Assessment Tool (EAT-10), 819 Eating habits, 868 Efferent nerves, 4, 31–32 Effortful swallow, 167 Electrical stimulation therapy, 766–767 Electrostimulation, of lingual nerve, 37 Encephalopathy, 215 Endoscopy, 134–135 dysphagia, differential diagnosis of, 540–541 fibre-optic endoscopic evaluation of swallowing, 529 advantages and limitations, 530 function, 529 vs videofluoroscopy, 531 hypopharynx, 527, 528 larynx indirect rigid, 526 transnasal flexible nasopharyngolaryngoscopy, 526–527 leukoplakia of vocal folds, 528 oesophagus diagnostic evaluation, 525 flexible oesophagoscopy, 534–540 rigid oesophagoscopy, 534, 540 symptoms, 533–534 ultra-thin oesophagogastroscopes, 540 upper gastrointestinal tract, 533 Index pharynx diagnostic evaluation, 525 direct rigid, 531–533 indications, 526 reflux laryngitis, 527 Reinke’s oedema, 528 vocal fold paresis, 528 Enteral feeding, 868–869 Enteral nutrition biliary and pancreatic secretions, 788 cognitive functions, 786 elective surgical intervention, 786 ethical aspects, 801–802 fluid intake, 786 gut absorptive function, 788–789 immunocompetent cells, 787 malnutrition, 793 medical ethics, 801–802 metabolism, 790–793 nutritional intake insufficiency, treatment (see Nutritional intake insufficiency) nutritional treatment evaluation, 801 solutions for, 796, 797 Enteral tube feeding (ETF), 798 Enteric nervous system (ENS), 146 Eosinophilic esophagitis (EoE), 387–388, 438–440, 476, 539, 605–606 Epidermolysis bullosa dystrophica, 237 Epiglottic musculature, 11 Epiglottis anterior surface of, core of, movement of, 12 swallowing disorders, 291, 293 Epiphrenic diverticula, 460–462 Epithelioid granulomas, 238 Erosive oesophagitis (ERD), 597, 604 Esophageal atresia, 408–409, 456 Esophageal carcinoma, 392–395 Esophageal diverticula, 304, 307 Esophageal dysmotility, 249, 250 bolus propagation, 774 bolus transport, 774 cervical and thoracic esophagus, 774 characteristics excitatory innervation, 776 inhibitory innervation, 776 overactive excitatory innervation, 777 deglutition, 775 esophageal intramural neurons, 775 esophageal sphincters, 773–774 HRM-pressure topography, 774, 775 local and systemic disease processes, 774 muscle types, 774 neurologic control, 774 peristalsis, 774 physiologic eructation/emesis, 773 striated muscle, 774 transition zone pressure, 775 911 Esophageal dysphagia, 282 Esophageal injury, 110 Esophageal motility disorders after antireflux/bariatric surgery, 464 classification, 449–450 Esophageal motor disorders, 427–430 Esophageal stenoses, 304–306 Esophageal transit disorders, 217 Esophagogastric junction (EGJ), 307, 308, 435–436 Esophagus ageing, 250–251 airway fistulas, 399–400 anatomy of, 15–16 CT and PET/CT technique, 502–503 achalasia, 514–515 aortic disease, 519–520 cross-sectional imaging, 502 diverticula, 515–516 duplication cysts, 516 dysphagia lusoria, 519–520 hiatal hernias, 516–517 malignancy, 510–514 multi-detector CT, 520 oesophageal cancer, 503–504 oesophagectomy, 509–510 oesophagitis, 517–518 tumour detection and classification, 504–509 varices, 517–518 diverticula, 396–397 downhill varices, 398 endoscopy (see Endoscopy) foreign body impactions, 398–399 high-resolution manometry anatomy, 420 esophageal motor disorders, 427–430 physiology, 421–422 inflammatory conditions alkaline reflux esophagitis, 389 caustic esophagitis, 389 drug-induced esophagitis, 387 eosinophilic esophagitis, 387–388 infectious esophagitis, 383–387 nasogastric intubation, 390 radiation esophagitis, 388–389 reflux esophagitis, 380–383 neoplasms benign tumors, 390–392 malignant tumors, 392–395 pediatric achalasia, 413 acquired functional abnormalities, 416 advanced imaging techniques, 407–408 dysphagia, 412 esophageal atresia, 408–409 esophageal narrowing causes, 409–410 fluoroscopy, 406–407 foreign-body ingestion, 413–414 gastroesophageal reflux, 412–413 gastrointestinal tract, 405 iatrogenic foreign bodies, 414–415 912 Esophagus (cont.) mucosal destruction, 415 perforation, 415–416 radiation dose reduction, 407 tracheoesophageal fistula, 408–409 vascular anomalies, 410–411 perforation, 400–401 radiologic evaluation, 445–446 diverticula, 460–462 dynamic MR imaging, 464–467 esophageal motility disorders, 449–450 esophageal motor function, 447–449 examination technique, 449 gastroesophageal reflux disease, 462–464 lower esophageal sphincter, 446 non-propulsive contractions, 446 primary and secondary peristalsis, 446 primary motor disorders, 450–456 secondary motility disorders, 457–460 rings, 396 swallowing disorders, 301, 303–308 uphill varices, 397–398 webs, 395–396 European Society for Clinical Nutrition and Metabolism (ESPEN), 825 European Society for Swallowing Disorders (ESSD), 669 Expiratory muscle strength training (EMST), 185, 186, 665 Extensional behaviour, rheology bubble collapse, 690 capillary breakup extensional flows, 690 contraction flows, 690 dysphagia-designed fluids, 691 dysphagia-designed puddings for nutritional support, 692, 693 dysphagia nutritional support, 689 entrance flows, 690 fibre spinning, 690 filament break-up rheometry, 691 filament stretching, 691 food oral processing and swallowing, 691 Newtonian fluid, 690 shear flow, 689 stagnation flows, 690 steady-state extensional viscosity, 692 surface tension values, 692 and swallowing process, 700 Trouton ratio, 690 uniaxial elongational flow, 689, 690 Extrapontine myelinolysis (EPM), 105 F FDG-PET/CT, 509 Feeding respiratory pattern, 58–61 Fiber-optic endoscopic evaluation of swallowing (FEES), 529, 654, 823 advantages and limitations, 530 function, 529 Index OD, 199 Parkinson’s disease, 184 with sensory testing, 654 swallowing disorders, 283 vs videofluoroscopy, 531 Flap surgery, 811 Flexible endoscopic evaluation of swallowing (FEES), 98–99 Flexible oesophagoscopy, 534–540 Fluid and electrolyte absorption, 787 Fluid secretion, 27–30 Fluoroscopy gastric banding, 487 pediatric esophagus, 406–407 Food allergy, 217 Food phobias with behavior disorder, 218 Food texture, 680 Foreign-body ingestion, 608 Frey syndrome, 31 Friedreich ataxia (FRDA), 104 Frontolateral vertical laryngectomy, 647 Functional chest pain clinical presentation, 148 definition, 148 Functional dysphagia, 149 Functional esophageal disorders, 148 clinical examination and evaluation, 149–150 functional chest pain, 148 functional dysphagia, 149 functional heartburn, 149 globus, 149 reflux hypersensitivity, 149 treatment, 150–151 Functional heartburn, 149 Functional lumen imaging probe (FLIP), 438 Functional magnetic resonance imaging (fMR), 146 G Gastroesophageal reflux (GER), 251 impedance planimetry, 440–442 pediatric esophagus, 412–413 Gastroesophageal reflux disease (GERD), 120, 130, 596 anti-reflux procedures, 601 atypical reflux symptoms, 599 complications, 596 delayed gastric emptying, 597 diagnosis, 131–132, 597, 599 endoscopy and biopsy, 134–135 GIS, 132 pH studies, 133 PPI trial, 133–134 RDQ, 132 RSI, 132–133 dose–response relationship, 596 erosions, 597 esophagus radiologic evaluation, 462–464 etiology, 121–122 failed open/minimally invasive surgery, 620–621 healing anastomosis, 604 Index Heller myotomy, 620 hiatal hernia, 597 impaired mucosal defensive factors, 597 impaired oesophageal clearance, 597 incidence, 596–597 investigation, 135 laparoscopic fundoplication, 600, 601 lower esophageal sphincter, 472–474 and LPR, 131 management, 135 medications, 135–136 surgery, 136–137 medical history, 597 medical treatment, 599 oesophageal manometry, 598–599 oesophago-gastro-duodenoscopy, 597 open, laparoscopic/robotic surgery, 599 outflow obstruction, 621 pathogenesis, 597 pathophysiology, 597 peristalsis, 621 pH-metry, 598–599 proton pump inhibitors, 597, 599 quality of life, 596 radiology, 599 retrosternal symptoms, 596 surgical management, 601 surgical treatment, 599–601 symptom relief, 599 treatment, 599 type IV hernia, 604 Gastrointestinal bleeding, 534 Gastrointestinal dysmotility, 236 Gastro-oesophageal Reflux Disease Impact Scale (GIS), 132, 138–139 Gene expression, 806 Genioglossus muscle, GERD, see Gastroesophageal reflux disease (GERD) Geriatric pharynx ageing brain, 244 dementia, 249–250 examination techniques, 246 nondysphagic elderly, 246–249 pharyngeal stage misdirected swallowing, 245 PES, 246 pharyngeal constrictors, 246 primary ageing, 244 Giant cell arteritis, 100 Gingivitis, 807–808 Globus, 137 functional esophageal disorders, 149 investigation, 137 treatment, 137 Globus hystericus, 272 Globus sensation, 81, 282, 534 Glossopalatal (tongue-soft palate) seal insufficiency, 822 Glossopalatine muscle, Glossopharyngeal muscle, Glossopharyngeal nerve, 17 913 Glutamic acid decarboxylase (GAD), 107 Glycogenic acanthosis, 390 Gothenburg Throat model, 547–548 Granular cell tumors, 391 Granular secretion, 29 Gugging Swallowing screen, 86 Guillain–Barré syndrome (GBS), 107, 154, 155 Gut absorptive function bacteria, 788 balanced intestinal microbial flora, 788, 789 barrier function, translocation, 789 immune function, 789 intestinal surface, 788 H Head and neck tumors chemoradiotherapy on mucosa, cartilages and muscles, 652–653 on swallowing function, 653–654 dysphagia aspiration pneumonia, 642 malnutrition, 642 management, 642 rehabilitation planning, 642 swallowing assessment, 642 incidence, 642 prevalence, 642 radiochemotherapy of, 111 regions and sites, 642, 643 surgical procedures advantages, 643 laryngeal cancer, 647–651 long-term morbidity, 643 oral cavity, 643–645 of oropharyngeal malignancy, 645–647 patient prognosis, 643 resectable, 643 unresectable, 643 Heartburn, 534 Heatshock cognate protein 70 (HSC70), 46 Hemi-pharyngectomy, 632 Herpes esophagitis, 384–385 Hiatal-and para-oesophageal hernias, 602–604 Hiatal hernia, 462 gastro-oesophageal reflux disease, 597 lower esophageal sphincter, 474–476 High-performance liquid chromatography (HPLC), 38 High-resolution manometry (HRM), 823–824 clinical implementation, 430 digital data acquisition methods, 419–420 esophagus anatomy, 420 esophageal motor disorders, 427–430 physiology, 421–422 pharyngeal anatomy, 420–421 dysphagia, 424–427 function, 422–423 intrabolus pressure, 423 physiology, 421 Index 914 High-resolution manometry (HRM) (cont.) UES anatomy, 420–421 compliance, 423 dysfunction, 423–424 physiology, 421 Histatin 1, 46 Histatin 3, 42 Histatins, 39 Hodgkin’s lymphoma, 395 Hormones, saliva, 32–33 Hospital Anxiety and Depression Scale (HADS), 874 HRM, see High-resolution manometry (HRM) Human immunodeficiency virus (HIV), 106 esophagitis, 386–387 Huntington disease, 103 Hydro-MDCT, 509–520 5-Hydroxytrytamine (5-HT), 146–147, 151 Hyoglossus muscle, Hyoid, 291, 294, 295 Hyoid bone, Hypersensitivity, 146 Hypodermoclysis (HDC), 858–859 Hypoglossal nerve, 17 Hypopharyngeal (Zenker) diverticulum, 124 Hypopharynx, 527, 528 Hysterical dysphagia, 272 I Iatrogenic causes ACSS, 111 CEA, 110–111 drugs, 110 head and neck cancers, radiochemotherapy of, 111 IBS, see Irritable bowel syndrome (IBS) ICU-related dysphagia, 153–154 diagnostic workup bedside screening, 156 CSE, 156 FEES, 156–157 etiology and pathophysiology, 154–156 management, diagnostic algorithms for non-intubated patient, 157 tracheotomized patient, 157–159 Idiopathic Parkinson syndrome (IPS), 101–102 Immune response, 809 Immunoglobulins, 28 Immunonutrition, 798 Impaired swallow, components of, 80–81 Impedance planimetry applications, 435 dysphagia achalasia, 437–438 eosinophilic esophagitis, 438–440 oropharyngeal dysphagia, 437 esophagogastric junction, 435–436 gastroesophageal reflux disease, 440–442 pharyngoesophageal sphincter, 437 technical principles, 434–435 tubular esophagus, 436–437 Ineffective esophageal motility (IEM), 781 Infantile pharynx, 628 Infectious diseases, 105–106 Inferior pharyngeal constrictor, Inflammation, 809 Inflammatory esophagogastric polyp, 381 Inflammatory muscle diseases, 109–110 Inflammatory myopathies, 239, 240 Insular loop, 93 Internal globus pallidus (GPi), 183 International Classification of Functioning (ICF) application, 871 environmental and personal factors, 871 ICF codes, 871–873 limitations, 873 people management, 874 International Dysphagia Diet Standardisation Initiative (IDDSI) Framework, 716 International terminology for texture-modified food, 839, 840 International terminology for thickened liquids, 839, 840 Intrabolus pressure (IBP), 423–424 Intrapharyngeal electrical stimulation, 766–767 In vitro models esophageal phase of swallowing, 549–552 oral phase of swallowing, 544, 545 pharyngeal phase of swallowing biomechanics, 545 Cambridge Throat model, 545–547 Gothenburg Throat model, 547–548 Newtonian bolus, 546 role, 544 swallowing device, 546 velocity profile, 548 simulation model, 549, 553–554 Iodide, 21 Irritable bowel syndrome (IBS) clinical presentation, 148 definition, 147 diagnoses of, 147 treatment, 148, 151 Isoprenaline, 33 J Jackhammer esophagus, 455–456 K Kangaroo Mother Care, 219 Kaposi sarcoma, 365, 367 Kennedy disease, 104 Killian-Jamieson diverticula, 353, 356–358 Index L Lambert-Eaton myasthenic syndrome (LEMS), 108 Large Zenker’s diverticulum, 355 Laryngeal cancer frontolateral vertical laryngectomy, 647 laryngopharyngectomy, 650–651 management, 647 morbidity, 647 partial laryngectomies, 647–649 total laryngectomy, 650–651 Laryngeal chemoreflex, 212 Laryngeal penetration, 80 Laryngeal vestibule closure (LVC), 164 Laryngectomy functional disorders, 626 and globus pharyngis, 630 in pharyngeal timing, 631 post-radiation, 630 postsurgical anatomy, 626 post-therapeutic, 626, 630 radiotherapy, 630 scarring, 631 voice prosthesis, 630 Laryngo-hyoido-mentopexy, 635 Laryngopharyngeal reflux (LPR), 130 Laryngopharyngectomy, 650–651 Larynx, 12–14, 291, 294, 295, 335–336 Lateral arytenoid muscle, 13 Lateral pharyngeal diverticula, 347–348 Leaking, 80 Leiomyomas, 390–391 LES, see Lower esophageal sphincter (LES) Lewy bodies, 172 Lichen planus, 237 Linear viscoelastic behaviour, rheology creep compliance function, 682, 683 evolution, linear relaxation modules, 682 experimental methods, 682 generalised Maxwell model, 684 linear constitutive equation, 681 modelling, 684 small-amplitude oscillatory shear, 683–684 stress relaxation, 682 thermodynamic forces, 681 Lingual nerve, 32, 37 Lipase, 20 Lip-splitting mandibulotomy approach (LSMA), 646 Listeria monocytogenes, 105 Lower esophageal sphincter (LES) achalasia, 476–478 benign and malignant stenoses, 474 dysphagia after bariatric surgery, 482–487 after surgical antireflux therapy, 481–482 eosinophilic esophagitis, 476 esophageal motor function, 447–449 esophagogastric outflow obstruction, 476 gastroesophageal reflux disease, 472–474 hiatal hernia, 474–476 915 non-propulsive contractions, 446 primary and secondary peristalsis, 446 stomach computed tomography, 477 inflammatory conditions, 479–480 symptoms, 471 videofluoroscopy, 472 Lower motor neuron (LMN), 94, 95, 162 Lung function, 181 Lymphocytes, 234 Lymphoid hyperplasia, pharynx, 353–354 Lymphomas computed tomograpy, 510–511 pharynx, 364, 374–375 M Magnetic resonance imaging (MRI), 498–499 Magnetoencephalography (MEG), 177 Malignancy-induced achalasia, see Pseudoachalasia Malignant minor salivary tumors, 365, 376 Mallory-Weiss bleeding, 609–610 Malnutrition, 786, 793 anthropometric measurements, 828 BIA, 828 body imaging techniques, 827–828 complications, 832–833 epidemiological observations, 833 impaired nutritional status, 832 muscle strength, 828 pathophysiology, 824–825 physical performance, 828 screening and assessment, 824–825 total/partial body potassium, 828 treatment, 838–839 types and mechanisms, 825–828 Malnutrition Advisory Group (MAG), 825 Malnutrition universal screening tool (MUST), 655, 825 Master neurons, 94 Maxwell model, 688 Mechanical dysphagia, 83–84 Mechanical thermal stimulation, oropharynx, 765 Mechanical ventilation, complications of, 110 Median thyrohyoid fold, 13 Megaesophagus, 459 Microstomia, 235 Middle pharyngeal constrictor, Midesophageal diverticula, 460, 461 Miller-Fisher syndrome (MFS), 107 Minimal enteral nutrition, 787 Mini-nutritional assessment (MNA), 87, 825 Minor salivary gland secretion, 41 MND, see Motor neuron disease (MND) Modified barium swallow study (MBSS), see Videofluoroscopic swallowing study (VFSS) Monoamine oxidase B inhibitors (MAOB-I), 181 Motor neuron disease (MND), 888 Mucins, 41 916 Mucosal surface, 14–15 Multidetector computed tomograpy (MDCT), 520 Multiple sclerosis (MS), 105, 498 Multiple system atrophy (MSA), 102, 173 Munich Dysphagia Test-Parkinson’s disease (MDT-PD), 102 Muscle atrophy, 95 Muscle diseases, 108 inflammatory muscle diseases, 109–110 muscular dystrophies, 109 prolonged mechanical ventilation and/or sepsis, complications of, 110 Muscle fibrosis, 239 Muscular dystrophies, 109 Myasthenia gravis (MG), 37, 108 Myoepithelial cell contraction, 30 Myo-/neurogenic disorders, 637 Myotomy, 128 Myotonic dystrophy type (DM1), 109 Myotonic dystrophy type (DM2), 109 N Narrow band imaging (NBI), 532 Narrow-field laryngectomy, 129 Nasal penetration, 80 Neck metastasis, surgery, 651–652 Neopharynx, 629 Neuroborreliosis, 106 Neurodegenerative diseases, 815 ALS, 888 dementia, 889 MND, 888 Parkinson’s disease, 889 Neurogenic dysphagia, 85 signs and symptoms, 96 Neuromuscular dysfunction combination of, 577 swallowing rehabilitation, 580 UES myotomy, 578–579 Neuromuscular electrical stimulation (NMES), 665, 738, 739, 767, 836 Neuromuscular junction, 217 LEMS, 108 myasthenia gravis, 108 Neurostimulation techniques, brain plasticity PAS, 745–746 peripheral stimulation, 736–742 repetitive TMS, 730–736 tDCS, 742–744 Neurotoxin, 176 Newborn individualized developmental care and assessment program (NIDCAP), 219 Nissen fundoplication, 416 NMS, see Non-motor symptom (NMS) Nociceptors, 25 Non-erosive GORD (NERD), 597 Non-Hodgkin’s lymphoma, 395 Index Non-linear viscoelastic behaviour, rheology, 685–689 non-linear viscoelasticity odelling, 688, 689 transient flow behaviour, 687–688 viscous flow behaviour, 685–687 Non-motor symptom (NMS), 177, 180 drooling and xerostomia, 180 lung function and cough, 181 Nonnutritive sucking, 211 Nonprogressive brain disorders (NPBD), 826 Nonpropulsive contractions, 301, 303 Noradrenaline, 26 Nucleus ambiguus (NA), 175–176 Nucleus tractus solitarius (NTS), 175 Nutcracker esophagus, see Jackhammer esophagus Nutricare program, 203 Nutritional intake insufficiency, 793–801 clinical outcome, 798, 801 complications, 800–801 contraindications, 801 energy and fluid needs, 795 energy demands estimation, 795, 796 enteral solutions, 796–798 immunonutrition, 798 nasogastric tube, 799 nutritional needs calculation, 795, 796 oral nutrition, 793 percutaneous endoscopic gastrostomy, 798–800 supplementation with enteral nutrition, 794 with parenteral nutrition, 794 tube systems for enteral nutrition, 794, 795 Nutritional management, dietitian’s role amylase-resistant thickeners, 715–717 clinical practice, 713 fluids, 717 foods, 717 Harris–Benedict equations, 714 hydration, 714–715 hydration and adherence, 717 malnutrition, 713 medications, 717 nutrition, 713–714 quality-of-life issues, 717–718 saliva contamination, 716 Schofield equations, 714 Nutritional risk screening (NRS), 825 Nutritional screening, 793 Nutritional support, 786–787 Nutritional support-product design dehydration, 697 dynamic triad strategy, oral nutritional supplements, 698 food consistencies, 698 Fresubin® Crème, 698, 699 malnutrition, 697 Varibar® Pudding, 698, 699 videofluoroscopy diagnostic fluids, 700 Nutritive sucking, 211 Index O Oculopharyngeal muscular dystrophy (OPMD), 109 OD, see Oropharyngeal dysphagia (OD) Odynophagia, 81 Oesophageal carcinoma, 537–538 Oesophageal diverticula, 606–608 Oesophageal dysphagia, 80 Oesophageal haemorrhage acute oesophageal necrosis, 610–611 aorto-oesophageal fistulas, 611 Dieulafoy’s lesion, 610 Mallory-Weiss bleeding, 609–610 oesophageal variceal bleeding, 609 Oesophageal perforations cervical perforations, 612 clinical manifestations, 611 diagnosis, 612 intrathoracic perforations, 612 non-operative management combined endoscopic and percutaneous procedures, 614 drainage procedures, 613 endoscopic clips, 614 mediastinal/pleural fluid collections, 613 oesophageal stent, 613–614 patient selection, 613 operative management, 614–615 pathogenesis, 611–612 pathophysiology, 611–612 treatment, 613 Oesophageal strictures, 604–605 benign peptic strictures, 604 complications to dilatations, 605 refractory strictures, 605 through-the-scope balloon catheter technique, 604 Oesophageal variceal bleeding, 609 Oesophageal webs, 539 Oesophagectomy, 509–510 Olfactory receptors, 25 Olfactory-salivary reflex, 25 ONS, see Oral nutritional supplements (ONS) Open partial horizontal laryngectomies (OPHL), 647 Oral care, dysphagia, see Periodontal disease Oral cavity, 317, 318, 643–645 Oral/enteral replacement, 857 Oral hygiene, 839–841 Oral motor exercises, 227, 665 Oral nutrition, 793 Oral nutritional supplements (ONS), 793, 794, 798, 801, 839 Orexigenic hormone, 213 Orogastric feeding tube, 787 Oropharyngeal cancer, 645 lateral pharyngotomy access, 645 mandibulotomy access, 645 transoral robotic surgery, 645–646 917 Oropharyngeal dysphagia (OD), 80, 196, 437 adjunctive biofeedback, 668–669 ageing, 814 aspiration and choking, 661 behavioral swallow therapy, 672 behavioral techniques, 663–669 bolus modification, 662, 664–665, 670, 671 bolus transport, 672 clinical assessment methods, 820 clinical efficacy, 669 clinical screening, 818, 819 complications, 199–200, 814 AP (see Aspiration pneumonia (AP)) malnutrition (see Malnutrition) deglutition-specific questionnaires, 819–820 diagnostic algorithm, 818, 819 diagnostic approaches, 198 clinical evaluation, 198–199 instrumental swallowing assessment, 199 drugs, 198 electromyographic biofeedback, 672 ESSD on, 669 evidence-based medicine, 663 facilitation techniques, 662 instrumental assessment FEES, 823 HRM, 823–824 videofluoroscopy, 820–823 intervention techniques, 663–664 labial awareness and control, 665 laryngeal adductor exercises, 662 medical treatments, 663 Mendelsohn maneuver, 672 motor behavioral techniques, 665 neuromuscular electrical stimulation, 669, 671–672 nutritional and respiratory complications, 829 nutritional supplements, 662 oral intake in patients, 672 oral motor exercises, 671 oropharyngeal motor response, 816, 817 oropharyngeal swallow response, 816 palliative care, 204 pathophysiology, 197 postural adjustments, 666 body postures, 666 head postural adjustment, 666–667 postural changes, 672 prevalence, 196–197, 814 radiation/surgical intervention, 662 respiratory complications (see Aspiration pneumonia (AP)) sarcopenia, 817 sensory and neurophysiologic stimulation, 665–666 severity of, 828 structural alterations, 815 submental muscles, 816 surgical treatment, 574, 580–583 swallowing mechanism, 662 Index 918 Oropharyngeal dysphagia (OD) (cont.) swallowing process, rehabilitation, 670, 671 swallowing therapy, 669 swallow maneuvers, 667 effortful swallow, 668 Masako maneuver, 668 Mendelsohn maneuver, 667–668 Shaker exercise, 668 super supraglottic swallow maneuver, 667 supraglottic swallow maneuver, 667 swallow response, 816 therapeutic interventions, 669 therapeutic strategies, 662, 841 tongue propulsion, 817 treatment, 200–203, 662, 818, 819 unilateral vocal fold paralysis, 670 whole-body and head-position strategies, 663 Oropharyngeal impairment, 76, 244 Oropharyngeal sensitivity ageing process, 756 and larynx, sensory innervation, 757–759 mechanical stimulation, 756 with neurodegenerative diseases, 756 pharyngeal sensory loss, 756 sensory receptors ASICs, 764–765 thermal and chemical stimuli, 762 TRPA1, 763–764 TRPC1, 764 TRPC6, 764 TRPM8, 764 TRPV1, 762–763 TRPV2, 764 TRPV3, 764 TRPV4, 764 stroke, supratentorial or infratentorial, 756 in swallow function free nerve endings, 760, 761 Krause bulbs, 760, 761 Meissner’s corpuscles, 760, 761 Merkel cells, 760, 761 Pacini corpuscles, 760, 761 taste buds, 760–762 Oropharyngeal swallow response (OSR), 755 Oropharynx and larynx, 757–759 Ostwald-de Waele’s model, 686 P Paired associative stimulation (PAS), 741, 745–746 Palatal cleft, 634–635 Palatopharyngeal isthmus, 65 Palatopharyngeal muscle, 10 Palliative care, 165–166, 204 Papillomas, 390 Paraneoplastic syndromes, 107 Parenteral feeding, 787 Parenteral nutrition, 786 Parenteral replacement HDC, 858–859 intravenous rehydration, 859–860 Parkinson’s disease (PD), 172, 889 dysphagia clinical assessment, 183–185 clinical features, 177–180 early-vs late-stage, 185 health outcomes, 187–188 neurophysiological studies for, 176–177 non-oral dopamine receptor agonists, 183 non-oral medical therapy, 183 pathophysiology of, 174–176 pharmacological therapy, 181–183 non-motor symptoms and, 180 drooling and xerostomia, 180 lung function and cough, 181 pathophysiology atypical parkinsonian syndromes, 173–174 medical diagnosis, 173 motor features, 172 UPDRS, 173 therapeutic approaches, 185–187 Parotid duct, 22 Partial laryngectomies, 648 PD, see Parkinson’s disease (PD) Pedunculopontine nucleus (PPN), 176 Pemphigoid, 237 Pemphigus, 237 Penetration, 69 Pepsin, 131 Peptic strictures, 381, 382 Percutaneous endoscopic gastroscopy (PEG), 186 Perinatal stroke, 215 Periodontal disease bacteria, 810 bone substitutes/tissue grafts, 811 gingivitis, 807–808 oral hygiene instructions, 810 pathogenesis, 808 periodontal maintenance, 811 periodontitis, 807–808 root planning, 811 SRP, 810, 811 supragingival and subgingival cleaning, 811 and systemic disease, 808–809 tooth structures, 807 treatment, 810 Periodontitis, 807–808 Peripheral hypersensitivity, 146 Peripheral stimulation air-puff pulse stimulation, 738 gustatory stimulation, 737, 738 neuromuscular electrical stimulation, 738 PES, 739–742 Peristalsis, videofluoroscopic assessment of, 448 PES, see Pharyngoesophageal segment (PES) Phagophobia, 272 Pharyngeal cavity, 334 Pharyngeal contraction, 824 Pharyngeal dysphagia, 282 Pharyngeal electrical stimulation (PES) corticobulbar excitability, 739 effects of, 740 Index Met BDNF allele, 742 nasogastric tube removal, 741 neurophysiological and behavioural effects, 739 randomised clinical trial, 740–742 single nucleotide polymorphism, 742 during volitional swallowing., 739, 740 Pharyngeal peristalsis, 424–425 Pharyngeal regurgitation, 81 Pharyngeal sensory evoked potentials (PSEP), 756 Pharyngeal swallow abnormal oral stage, 67, 68 pharyngeal stage, 68–72 cerebrovascular diseases, 74, 76 normal esophageal stage, 67 oral stage, 64–65 PES, 67 pharyngeal stage, 65–67 pharyngoesophageal segment, dysfunction of, 72–73 radiologist, role of, 76 specific disease entities, radiologic evaluation, 73–75 Pharyngeal weakness, 295–296 Pharyngoceles, 296–297 Pharyngo-esophageal nerve (PEN), 95 Pharyngoesophageal segment (PES), 10–12, 65–67, 246 dysfunction of, 72–73 pharyngeal swallow, 67 swallowing disorders, 297–301 Pharyngoesophageal sphincter, 437 Pharynx acute pharyngitis, 354, 358 adenocarcinoma, 376 in adults, 628 anatomy of cartilages, 2–4 muscles, 4–12 benign tumors, 360, 366, 367 chronic inflammatory conditions, 358–359, 364 dysphagia, 317, 318 endoscopy (see Endoscopy) high-resolution manometry anatomy, 420–421 dysphagia, 424–427 function, 422–423 intrabolus pressure, 423 physiology, 421 hypopharynx, arcuate lines in, 346 in infants, 628 kaposi sarcoma, 365, 367 lymphoid hyperplasia, 353–354 lymphomas, 364, 374–375 malignant minor salivary tumors, 365, 376 morphological characteristics, 335–336 postcricoid mucosa, 349 pouches and diverticula, 347 branchial cleft cysts, 348–349 fistulas, 348–349 Killian-Jamieson diverticula, 353, 356–358 919 lateral pharyngeal, 347–348, 351, 352 lateral pharyngeal diverticula, 347–348 thyrohyoid membrane, 350 Zenker’s diverticulum, 349–351, 354–356 roentgen interpretation, 345 lines of, 348 palatine tonsils, mucosal surface of, 347 pharyngeal mucosa, 346 postcricoid mucosa, 349 tongue, mucosal surface base of, 346 scarring and postsurgical instabilities, 636 squamous cell carcinomas, 361–364, 368–373 structural abnormalities, 345 surgical treatment, 574 synovial sarcomas, 365 webs, 359–360, 365 Pica, 218 Pick eating, 218 Piriform sinus carcinomas, 363 Pneumonia, 245 Poliomyelitis, 106 Polymorphism, of salivary proteome, 41–43 Polymyositis (PM), 109 Polyneuritis cranialis, 107 Positron emission tomography (PET), 146 Post-polio syndrome (PPS), 106 Post-therapeutic pharyngeal cancer, 632 Potassium, 27 Power-law, 686 PPI, see Proton pump inhibitor (PPI) Predeglutitive aspiration, 822 Preganglionic nerve fibres, 31–32 Presbyesophagus, 250–251, 456 Primary angiitis of the CNS (PACNS), 100 Primary central nervous system vasculitis (PCNSV), 100 Primary motor disorders achalasia, 450–453 diffuse esophageal spasm, 454–455 esophageal atresia, 456 Jackhammer esophagus, 455–456 nonspecific contraction abnormalities, 456 presbyesophagus, 456 pseudoachalasia, 453–454 Primary-progressive course (PPMS), 105 Primary Sjögren’s syndrome (PSS), 233–234 Primary vasculitides, 99 Progressive/solid food dysphagia, 604 Progressive supranuclear palsy (PSP), 102, 173 Progressive systemic sclerosis (PSS), 457–458 Proline-rich proteins (PRPs), 39 Propionibacterium acnes, 45 Protective functions, 20 Protein secretion, 27–30 Proteome, human minor salivary gland secretion of, 41 Proton pump inhibitor (PPI), 120, 136–137, 149–150 PRP-1 Roma-Boston pSer22 → Phe (PRP-1 RB), 43 Pseudoachalasia, 453–454, 478 Pseudobulbar palsy, 94–95 Pseudodysphagia, 272 Pseudo-Zenker’s diverticulum, 356 Index 920 Psychogenic dysphagia, 272 epidemiology, 273–274 swallowing evaluation, 274–275 symptoms in, 272–273 treatment, 275–276 Psychological behavior management program, 275 Pulsion diverticula, 396–397 R Radiation esophagitis, 388–389 Radiochemotherapy, of head and neck cancers, 111 Recurrent laryngeal nerve (RLN), 95 Recurrent respiratory papillomatosis, 532 Reflux, 120 Reflux Disease Questionnaire (RDQ), 132, 138 Reflux esophagitis, 415, 536 Barrett’s esophagus, 381–383 double-contrast view, 381 manifestation, 380 peptic scarring and strictures, 381, 382 severity, 380 (see also Esophagus) Reflux hypersensitivity, 149 Reflux laryngitis, 527 Reflux Symptom Index (RSI), 132–133 Regurgitation, 534 Rehydration and prevention, 857 Reinke’s oedema, 528 Relapsing-remitting onset (RRMS), 105 Repetitive transcranial magnetic stimulation (rTMS) cerebellum and neurostimulation, 735, 736 cortical, 730–735 Respiration, 60 Retention, 80 Retrocardiac chest pain, 534 Rheology deformation process, 680 description, 680 extensional behaviour, 689–693 food behaviour, 680 linear viscoelastic behaviour, 681–685 material viscoelasticity, 681 non-linear viscoelastic behaviour, 685–689 in nutritional support-product design, 697–700 in swallowing process, 693–697 Rheumatoid arthritis, 234–235 Rigid oesophagoscopy, 534 vs flexible, 540 Rotigotine, 183 320-row area detector computed tomography (320-ADCT), 328 dynamic analysis age, 337 bolus consistency, 337–339 bolus volume, 337 hyoid distance, 339 hyoid muscle shortening, pattern of, 339–340 laryngeal movement, 339 pharyngolaryngeal space during swallowing, 339 TVC closure, 337 UES opening, cross-sectional area of, 339 static 3D images larynx and pharynx anatomy, 335–336 pyriform sinus volume, 336–337 S Safe deglutition, 174 Saliva ageing, 34 autonomic transmitters and receptors, 26 blood flow, 30–31 dry mouth causes of, 35–36 treatment of, 36–37 efferent nerves, 31–32 fluid and protein secretion, 27–30 functions of, 20–21 glandular origin, sensory nerves of, 32 hormones, 32–33 human minor salivary gland secretion, proteome of, 41 human saliva and post-translational modifications, protein components of, 38 major and minor salivary glands and mixed, 22 myoepithelial cell contraction, 30 nerves, trophic effects of, 33–34 pathological modifications, 46–48 physiological variability, 43–45 polymorphism of the salivary proteome, 41–43 salivary centres, 31 salivary proteins, function of, 45–46 salivary proteome, 38–41 salivary response displays circadian and circannual rhythms, 23 diversity of, 23–24 secretion, 25–26 secretory units, 27 sialorrhoea, 37–38 spontaneous, resting and stimulated secretion, 22–23 xerostomia, salivary gland hypofunction and dry mouth, 34–35 Salivary centres, 31 Salivary gland exocrine function of, 21 hypofunction, 34–35 major and minor, 22 Salivary proteins, function of, 45–46 Salivary proteome, 38–43 Sarcoidosis, 238 Sarcopenia, 827–828 Scaling and root planing (SRP), 810, 811 Scleroderma, 235, 236 S-cystatins, 43 Secondary motility disorders Chagas disease, 459 diabetes mellitus, 459 progressive systemic sclerosis, 457–458 Index Secondary-progressive MS (SPMS), 105 Secondary vasculitides, 100 Sedatives, 110 Sensitive esophagus, 133 Sensorimotor impairments, 163 Sensory nerves, of glandular origin, 32 Sensory stimulation treatments for oropharyngeal dysphagia (see also Oropharyngeal sensitivity) chemical and pharmacological stimulation, 765–766 electrical stimulation, 766–767 mechanical and thermal stimulation, 765 sensory perception, 765 swallow neurophysiology, 765 pathophysiological study, 767 peripheral sensitivity and neurophysiology, 767 stroke and neurodegenerative disease, 767 Sepsis, complications of, 110 Serotonin, 151 Short-chain fatty acids (SCFAs), 787 Sialorrhoea, 37–38 Simulation model, 549, 553–554 Sisko’s model, 687 Sitophobia, 272 Sjögren’s syndrome, 45, 48 Sleeve gastrectomy, 486 Small Zenker’s diverticulum, 354 Sodium, 27 Soft palate, 291, 292 muscles, 6, Soor oesophagitis, 538 Space-occupying masses, 297 Speech and language therapist (SLT), 713 Spinal muscular atrophies (SMAs), 104 Spinobulbar muscular atrophy (SBMA), 104 Spinocerebellar ataxias (SCA), 104 Spontaneous swallowing, 58 Sporadic ataxias, 104 Sporadic inclusion body myositis (sIBM), 109 Squamous cell carcinomas esophagus, 394 pharynx, 361–364, 368–373 Stapler diverticulotomy, 576 Starvation and cancer, 792–793 fluid supply, 790 glycogenolysis, 790 pathophysiological processes, 791 and trauma/sepsis, 790, 791 Starvation-related malnutrition, 825 Statherin, 46 Steamboat laryngoplasty, 129 Stensen’s duct, 22 Stiff-person syndrome (SPS), 107 Stroke, 85, 99–101, 495–497 Styloglossus muscle, Stylohyoid ligament, Stylohyoid muscles, Stylopharyngeal muscle, 11 921 Subcortical arteriosclerotic encephalopathy (SAE), 99 Subcortical ischemic vascular dementia (SIVD), 99 Subgingival plaque, 806 Subjective global assessment (SGA), 825, 826 Substance P (SP), 26, 32, 112 Subthalamic nucleus (STN), 183 Sucking–swallowing disorders, 217 Supersensitivity, 33 Super-supraglottic swallow, 167 Supplementary motor area (SMA), 93 Suprabulbar lesions, 215 Supracricoid laryngectomies (SCL), 647–650 Supragingival plaque, 806 Supraglottic carcinomas, 362 Supraglottic partial laryngectomy, 647 Supraglottic pharyngolaryngeal resection, 632 Supratracheal laryngectomies, 647 Surface electromyography (sEMG), 220, 275 Surgical treatment dysphagia, 574 anterior cervical osteophytes, 584–585 anterior–lateral surgical extrapharyngeal approach, 585 fibrosis and strictures, of pharynx, 587–591 meningoceles, 585 retropharyngeal tumor mass, 586–587 type neurofibromatosis, 585 neuromuscular dysfunction, 577–580 oropharyngeal dysphagia, 574, 580–583 pharynx, 574 of swallowing disorders, 574 Zenker’s diverticulum contraindications, 576 diverticuloesophageal wall, 576 endoscopic treatments, 575 flexible endoscopic treatment, 576 mediastinitis, 575 postoperative management, 576 stapler diverticulotomy, 576 Swallowing apnea, 58 apparatus, aspiration, 81–82 after cerebral cortex damage, recovery, 727–728 clinical examinations BSE, 96–97 CSE, 97–98 neurogenic dysphagia, signs and symptoms, 96 CNS, diseases of ALS, 103–104 APS, 102–103 ataxias, 104 brain/skull base, tumors of, 104–105 Chiari malformations, 106 CPM, 105 dystonia, 103 Huntington disease, 103 infectious diseases, 105–106 IPS, 101–102 multiple sclerosis, 105 922 Swallowing (cont.) paraneoplastic syndromes, 107 SMAs, 104 stroke, 99–101 syringomyelia and syringobulbia, 106 Wilson disease, 103 cranial nerves eagle syndrome, 108 GBS, 107 tumors, 107 diagnostic procedure, 86–87 basic diagnostic procedure, 87 patient history, 87 dominance, 92, 93 dysphagia and, 80, 83 impaired swallow, components of, 80–81 mechanical dysphagia, 83–84 neurogenic dysphagia, 85 patient, clinical symptoms of, 85–86 and swallowing complaints, 81 dysphagia-designed fluid-saliva interaction, 701–703 examinations, 88 iatrogenic causes ACSS, 111 CEA, 110–111 drugs, 110 head and neck cancers, radiochemotherapy of, 111 impairment, 866–868 instrumented methods, 98–99 muscle diseases, 108 inflammatory muscle diseases, 109–110 muscular dystrophies, 109 prolonged mechanical ventilation and/or sepsis, complications of, 110 neuroanatomy and neurophysiology, 91–92 brainstem, 93–94 cerebral hemispheres, 92–93 pseudobulbar and bulbar palsy, 94–95 neuroanatomy and physiology of, 17–18 neuromuscular junction LEMS, 108 myasthenia gravis, 108 neurophysiological substrates, 724–726 neurostimulation techniques (see Neurostimulation techniques, brain plasticity) phobia, 272 physiological process, 680 potential, 93 saliva, role of, 700–703 screening procedures, 86 shear rheology bolus transit velocities, 694, 695 bolus transit velocity, 694 dietary management, dysphagia, 697 dysphagia management process, 693 fluid kinematics, 694 instrumental models, 694 kinematic analysis of dysphagia, 694, 695 non-radiological techniques, 694 Index videofluoroscopic swallowing study, 696, 697 videofluoroscopy, 694 viscosity, 694 special diagnostic approaches, 111–112 temporal coordination of, 60, 61 therapy pharmacotherapy and new therapeutic approaches, 112–113 upper esophageal sphincter, interventions against dysfunction, 112 Swallowing disorders, 625 adapted physiology, 627–629 chemoradiotherapy clinical examination, 654 FEES, 654 functional rating scales, 655 malnutrition, 655 swallowing evaluation, patient, 654 treatment, 655–656 imaging amount of contrast medium, 289 contrast medium, type of, 288, 289 epiglottis, 291, 293 esophagus, 301, 303–308 hyoid and larynx, 291, 294, 295 pharyngeal constrictors, 294–297 pharyngoesophageal segment, 297–301 seven functional units, 285, 286 soft palate, 291, 292 with suspicion of aspiration, 286 technical considerations, 284–285 tongue, 289–291 videofluoroscopic scripts, design of, 286 videofluoroscopy, standard positions for, 286–288 without suspicion of aspiration, 286 iso-osmolar iodine solution, 629 morphological and functional abnormalities, 629 multidisciplinary evaluation, 283–284 oro-hypopharyngeal neoplasm, 629, 630 symptoms aspiration, 282–283 esophageal dysphagia, 282 globus sensation, 282 medical history, taking the, 280–281 pharyngeal dysphagia, 282 Swallowing quality of life (SWAL-QOL), 871 Swallow neurophysiology, 756–757 Swallow response time (SRT), 93 Synovial sarcomas, 365 α-Synucleinopathy, 173 Syringobulbia, 106 Syringomyelia, 106 Systemic disease Behỗet disease, 237238 berylliosis, 238239 epidermolysis bullosa dystrophica, 237 inflammatory myopathies, 239, 240 lichen planus, 237 Index pemphigus and pemphigoid, 237 PSS, 233–234 rheumatoid arthritis, 234–235 sarcoidosis, 238 scleroderma, 235, 236 SLE, 236 Systemic lupus erythematosus (SLE), 236 Systemic sclerosis (SSc), 235, 236 T Temporal arteritis, 100 Temporomandibular joint, 234 Tetracycline, 387 Therapeutic videoradiographic swallowing study (TVSS) assessment, 558 assistant nurse, 560 availability, 558 comprehensive examination, 558 digital technique, 558 food and liquid textures, 559 management critical component, 566 diet modification, 569–568 effortful swallow, 568 Mendelsohn maneuver, 568 oral motor exercises, 568 oral vs nonoral feeding, 569 postural techniques, 566–567 sensory improvement techniques, 567 supraglottic swallow and super-supraglottic swallow, 567 swallowing maneuvers, 567 observation, 557 optimal position, 559 pathologist, 560 protocol, 562–564 radiation dose, 559 radiologist, 560 recording equipment, 559 test material, 560–565 upright position, 559 Thymectomy, 105 Thyroarytenoid muscle, 13 Thyroid cartilage, 2–5 Tongue muscles, surgery commando procedure, 644–645 glossectomies, 644 swallowing disorders, 289–291 Toronto Bedside Swallowing Screening Test (TOR-BSST), 86, 97 Total laryngectomy (TL), 650–651 Tracheoesophageal fistula, 408–409 Traction diverticula, 397 Transcranial direct current stimulation (tDCS), 742–744, 836 Transcranial magnetic stimulation (TMS), 92 923 Transcutaneous electrical stimulation, 767 Transient lower esophageal sphincter relaxation (TLESR), 776 Transient receptor potential channel subfamily A member (TRPA1), 762–764 Transient receptor potential channel subfamily V member (TRPV1), 762–763 Transient receptor potential subfamily M member (TRPM8), 762, 764 Transient Receptor Potential Vanilloid (TRPV1), 738 Transnasal esophagoscopy (TNE), 124–125 Trypsin, 38 Tubular esophagus, 436–437 Tyrosylprotein sulfotransferase (TPST), 42 U Ulcers, 236 Ultrasonography, 324 UMN disease (UMND), 103 Unified Parkinson’s Disease Rating Scale (UPDRS), 173 Upper esophageal sphincter (UES), 92, 127–128 high-resolution manometry anatomy, 420–421 compliance, 423 dysfunction, 423–424 physiology, 421 interventions against dysfunction, 112 myotomy, 578–580 swallowing disorders, 283 Upper motor neuron (UMN), 94, 162 Upper respiratory tract disease, 217 V Vagus nerve, 17 Vasculitides, 99 Ventrolateral CPGs (vlCPGs), 94 Video-assisted swallowing therapy (VAST), 186 Videoendoscopy (VE), 327 Videofluorography (VF), 327 Videofluoroscopic swallowing study (VFSS), 98–99, 123, 124, 280, 557 Videofluoroscopy (VFS), 183 achalasia, 451 vs FEES(ST), 530–531 lower esophageal sphincter, 472 OD, 199 swallowing disorders, 283, 284 Videopharyngography, 358 Videoradiography, 324–325 Viral oesophagitis, 538 Visceral hypersensitivity, 146–147 Vocal fold granuloma, 531–532 Voltage-gated calcium channels (VGCC), 108 Volume-viscosity swallow test, (V-VST), 814, 820, 821 924 W Wagner’s model fitting, 688, 689 Wallenberg syndrome, 94 Water swallow tests (WST), 156 Web, 299, 301 Wilson disease, 103 X Xerostomia, 34–35, 180, 235, 236, 653 X-linked Duchenne muscular dystrophy (DMD), 109 X-ray, dysphagia, 323 Index Z Zenker’s diverticulum (ZD), 248–249, 299, 301–303 cricopharyngeal dysfunction, 426–427 pharyngeal morphology, 349–351, 354–356 surgical treatment contraindications, 576 diverticuloesophageal wall, 576 endoscopic treatments, 575 flexible endoscopic treatment, 576 mediastinitis, 575 postoperative management, 576 stapler diverticulotomy, 576 Zimm theory, 690 ... Sweden ISSN 094 2-5 373 ISSN 219 7-4 187 (electronic) Medical Radiology ISBN 97 8-3 -3 1 9-6 857 1-7 ISBN 97 8-3 -3 1 9-6 857 2-4 (eBook) https://doi.org/10.1007/97 8-3 -3 1 9-6 857 2-4 Library of Congress... enjoy! Malmö, Sweden Olle Ekberg v Contents Part I: Anatomy and Physiology natomy and Physiology A Olle Ekberg and Göran Nylander aliva and the Control of... 237 D Thomas Mandl and Olle Ekberg he Geriatric Pharynx and Esophagus 247 T Olle Ekberg oice and Dysphagia