Dysphagia

by Katrina M. Jensen, Fort Worth, Texas, USA

DEFINITION AND INCIDENCE

Dysphagia is a general term used to describe a problem with the ability to swallow food and/or liquid by mouth. The problem itself can occur anywhere along the oral intake process from the very first stages of a person’s ability to hold and process food in the mouth, the process of passing this material through the throat or pharyngeal region, to how well it passes through the esophagus and into the stomach [1].  If there is an abnormality in how food or liquid is transported, anywhere along this pathway from the mouth to the stomach, the person is experiencing dysphagia.

The incidence of dysphagia in the laryngectomy population as reported, varies greatly with 10-68% [2] of the population experiencing some form of dysphagia.  The greatest incidence is reported in patients soon after the laryngectomy surgery, within weeks of discharge, with that number less in patients 2-3 years following surgery. [3] The nature of the problem, as well as the severity can vary equally so. Laryngectomees typically present with dysphagia problems that are typically different from non-laryngectomized patients experiencing dysphagia and, in many cases, the problem is also managed differently [2]. Typically speaking, the dysphagia found in laryngectomy patients is a result of anatomical changes which then have an impact on the normal physiology (or mechanics) of swallowing. In addition, the effects of radiation therapy can also have an impact on swallow function, especially in the laryngectomy population where the radiation field involves structures critical to the swallowing process [2].