Rehabilitation of swallowing disorders.

Optimal rehabilitation of dysphagia requires an understanding of normal and diseased physiology, a systematic functional evaluation of the patient's disability and a wide repertoire of rehabilitative techniques. Nonsurgical techniques should be used first, especially when the possibility of spontaneous improvement exists. Cricopharyngeal myotomy is effective in a patient with obstruction at the cricopharyngeal level and good airway protection. When oral feeding is not possible, esophagostomy is usually the preferred bypass procedure.