What is the pathophysiology of dysphagia?

Updated: Mar 20, 2020
  • Author: Nam-Jong Paik, MD, PhD; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Answer

Aspiration is a term referring to the passive entry of any food item into the trachea (eg, during inhalation), although the word often is used to denote any entry of a bolus into the trachea in any manner

Penetration refers to the active entry of any food item into the trachea (eg, during swallowing), although the term often is used to denote the entry of any bolus into the laryngeal vestibule

A lesion in the cerebral cortex or the brainstem can cause swallowing disorders as a result of the following:

  • Decrease in range of motion (ROM) of muscles of mastication and bolus propulsion, especially those responsible for buccal, labial, and lingual strength and the cricopharyngeus

  • Decreased sensation

  • Delayed or absent pharyngeal swallowing and reductions in pharyngeal peristalsis [10]

  • Delayed or absent laryngeal adduction and elevation

The locations of specific lesions, however, do not show correlation with findings on computed tomography (CT) or magnetic resonance imaging (MRI) scans.

Disorders of swallowing may be categorized according to the swallowing phase affected. A number of dysphagic problems can be identified during each phase of deglutition.


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