Swallowing disorders. Diagnosis and therapy.

Normal swallowing is a complex, rapid neuromuscular function. Causes for dysfunctional swallowing are protean. Appropriate workup includes a careful history, thorough physical examination of the head and neck, videofluorographic swallowing study, and when appropriate, manometry and endoscopy under anesthesia. Many swallowing problems are not easily curable or reversible, but most patients experience some improvement through the intensive efforts of a multidisciplinary team. The otolaryngologist-head and neck surgeon plays a key role in both evaluation of patients with dysphagia and in surgical intervention for selected cases of cricopharyngeal motor dysfunction and chronic aspiration.