Rehabilitation of swallowing disorders
Swallowing physiology: ingestion-swallowing phase
It is generally divided into 6 phases, including: awareness of food (cognitive phase, prior phase), eating, chewing and food mass formation, food entering the pharynx (oral phase), food mass passing through the pharynx (pharyngeal phase), and food mass passing through the esophagus (esophageal phase).
Definition of swallowing disorder
Difficulty in eating due to impaired function of the jaw, lips, tongue, soft palate, pharynx, esophageal sphincter, or esophagus that prevents safe and effective delivery of food from the mouth to the stomach to obtain adequate nutrition and hydration.
Any disease in the passage through the mouth to the stomach can cause swallowing disorders, such as occupying lesions in the oropharyngeal cavity, esophageal tumors, chemical burns, neurological diseases, and pharyngeal muscle weakness.
The complication rate in the acute phase is drafted (29%-60%), and some patients can recover on their own around 2w.
Common causes
1.Abnormal feeding passage
Surgery such as head and neck cancer surgery, laryngeal and tracheotomy, chemical burns, burns, etc.
2.Functional swallowing disorder
Temporary loss of nerve control of muscles involved in feeding activities (neurological disease). Uncoordinated muscle and bone movements (old age, dementia; myasthenia gravis).
Classification of swallowing disorders
1.According to the presence or absence of anatomical abnormalities
(1) Functional swallowing disorder: there is no anatomical abnormality, and it is a disorder caused by abnormal oropharyngeal and esophageal movements.
(2) Organic swallowing disorder: it is a swallowing disorder caused by anomalies in the anatomical structure of the mouth, pharynx, larynx and esophagus. Commonly, there are: inflammation, injury, tumor (head and neck) trauma surgery or radiation therapy of swallowing channel and adjacent organs, etc.
2.According to the site of occurrence
(1)Oropharyngeal swallowing disorder
(2)Esophageal swallowing disorder
Swallowing disorder complications
1.Complemented with dysarthria and difficulty in ingestion
2.Difficulty in verbal communication
3.Malnutrition, dehydration and aspiration pneumonia
4.It is an independent risk factor for death in stroke patients.
Consequences of swallowing disorder
1, misaspiration: due to the adjoining relationship between trachea and esophagus, solid food fluid oropharyngeal secretions can enter the respiratory tract through the vocal cords.
2, misaspiration pneumonia: solid or fluid, acute or chronic misaspiration of oropharyngeal secretions and reflux of gastric contents can lead to misaspiration pneumonia.
3, malnutrition: malnutrition associated with swallowing disorders is often caused by fear of eating, swallowing difficulties, and indigestion.
4, dehydration: lack of sufficient water and electrolytes in body tissues to maintain health.