benign lesions of the larynx – swallowing disorders€¦ · benign lesions of the larynx –...
TRANSCRIPT
![Page 1: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/1.jpg)
Benign lesions of the larynx – swallowing disorders
SemmelweisUniversityDept.ofOtorhinolaryngologyHeadandNeckSurgery
![Page 2: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/2.jpg)
Anatomy I. – the cartilageous trachea and larynx
![Page 3: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/3.jpg)
Anatomy II. – the lumen of the larynx
![Page 4: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/4.jpg)
Anatomy III. – the muscles of the larynx
• 1. „Outer muscles”: M. sternothyreoideus, m. thyreohyoideus, m. constrictor pharyngis inf.(m.thyreo- és cricopharyngeus)
• 2. „Inner” muscles: a: abductors – glottis opening b: adductors – glottis closure c: extensors – tense the vocal chords • 3. Muscles with no direct attachment to the larynx (m.
sternocleidomastoideus,...)
![Page 5: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/5.jpg)
Muscles I. – the abductor
m. cricoarytenoideus posterior (m.posticus)
![Page 6: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/6.jpg)
Muscles II. – the adductors
m.cricoarytenoideus lateralis m.interarytenoideus
m.thyreoarytenoideus internus (m.vocalis) és externus
![Page 7: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/7.jpg)
Muscles III. - „tensors”
m.cricothyreoideus, m.vocalis
![Page 8: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/8.jpg)
Movements
![Page 9: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/9.jpg)
Examination I. – indirect laryngoscopy
![Page 10: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/10.jpg)
Examination II. – direct laryngoscopy with flexible instument
![Page 11: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/11.jpg)
Examination III. – direct laryngoscopy with flexible instrument
- minimal mucosal anaesthesia needed - can easily be performed - archivation - fiberoptic or „chip on the tip”
![Page 12: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/12.jpg)
Examination IV. – direct laryngoscopy with rigid instrument
• betterpicturequality(comparedwithfiberoptic)• alittlebitlesstolerable• archivation
![Page 13: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/13.jpg)
Examinations V. – Videostroboscopy
• Principle: the vocal chords are illuminated with a slightly differentfrequencyofpulsatinglightcomparedtotheirownactualfrequency,
• theperiodsofthevocalchordsseemtobesloweddown
![Page 14: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/14.jpg)
Voice production (cover-body)
![Page 15: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/15.jpg)
Examinations VI. – voice analysis
oscillogram
voice spectrum
![Page 16: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/16.jpg)
Examinations VI. – voice analysis
![Page 17: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/17.jpg)
Examinations VI. – voice analysis (jitter – shimmer)
Normal valuesPeriod-flutter (jitter) < 1.04%
< 83.2µsamplitude-flutter (shimmer) < 3.81%
< 0.35dB
![Page 18: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/18.jpg)
Examinations VII. – laryngomicroscopy
![Page 19: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/19.jpg)
Larynx
• airwayprotection• valsalva• phonation
• exhaledvolumeofair• phonatorysettingsandvibrationsofvocal
chords• softtissueabovetheglottis-theplaceof
articulation
![Page 20: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/20.jpg)
![Page 21: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/21.jpg)
Diseases affecting voice production
• congenitalmalformationsoftheupperairways• inflammatorydiseasesofthelarynx• injuries• benignandmalignantlesions• disordersofmutation• endocrindisorders• neurologicaldiseases• functionalproblems(psychic...)
![Page 22: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/22.jpg)
Inflammatory diseases – laryngitis
![Page 23: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/23.jpg)
Inflammatory diseases – cyst of the vocal chord
![Page 24: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/24.jpg)
Inflammatory diseases – nodulus laryngis
Possible causes:
- deficient voice production
- overstrained voice
![Page 25: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/25.jpg)
Inflammatory diseases – polypus ch.voc.
Overstrained vocal chord i.e. during acute laryngitis
Treatment: surgical removal
![Page 26: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/26.jpg)
Papilloma laryngis
![Page 27: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/27.jpg)
Inflammatory diseases – Reinke-edema
• typicalsmoker’sdisease,morefrequentamongwomen• edemaappearsunderthemucosaofthevocalchords• treatment:surgicalremoval
![Page 28: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/28.jpg)
Intubation granuloma
![Page 29: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/29.jpg)
Inflammatory diseases – atrophia of m.vocalis (spindle-shaped closure defect)
Cause:overstrained phonation in acute laryngitis
Treatment: vocal exercises
![Page 30: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/30.jpg)
Closure defect in the posterior third of the glottis
![Page 31: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/31.jpg)
Closure defect in the whole lenght of the glottis
![Page 32: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/32.jpg)
Disorders of mutation
• delayed,long-lasting,early
• incomplete• perverted(women)• eunuchoidvoice(men)
![Page 33: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/33.jpg)
Neurological diseases – multiple sclerosis
• monotonousspeech• weak,hoarsevoice
![Page 34: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/34.jpg)
Neurological diseases – recurrent nerve palsy
• mostlyiatrogenic–afteroperationsofthethyroidgland• inunilateralcasesthehealthysidecompensatesthepalsy• thevoicetemporarilybecomesweak
![Page 35: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/35.jpg)
Bilateral recurrent nerve plasy causing dyspnea
![Page 36: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/36.jpg)
Neurological disorders – after cerebral hemorrhage
![Page 37: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/37.jpg)
Regulatory (functional) disorders
![Page 38: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/38.jpg)
dysplasia
![Page 39: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/39.jpg)
SCC of the vocal chord
![Page 40: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/40.jpg)
Voice rehabilitation after total laryngectomy
![Page 41: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/41.jpg)
Esophageal speech
• about 2/3 of the patients ara able to learn the technique and 1/3 of these uses regularly
• the patient can only tell short sentences
• poor, but understandable voice quality
![Page 42: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/42.jpg)
Electrolarynx
![Page 43: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/43.jpg)
Voice prosthesis
![Page 44: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/44.jpg)
Swallowing disorders
2018. 09. 16.
![Page 45: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/45.jpg)
2018. 09. 16.
Phases of swallowing
• oral-(gyruspraecentr.,premot.cortex,tr.corticobulbaris)
• relaxedmandible• lipsreachingeachother• tipofthetongueininferiorposition• bodyofthetonguereachesthesoftpalate• nasalbreathing• closedteethandlips• tonguereachestheaveolararch• tonguepressedagainstthehardpalate• bodyofthetongueinlowestposition• bolusmovesposteriorly–reachesthetriggerpoint
![Page 46: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/46.jpg)
Phases of swallowing
• pharyngeal(cca1s,med.obl.,n.X.)• velopharyngealclosure• hyoidboneelevates• laryngealclosure
• vocalchords• falsevocalchords• arytenoids,aryepiglotticfolds• retractionoftheradixepiglottisclosestheaditus
• pharyngealperistalsis• larynxelevates(cca.2cm),movesanteriorly,esophagusopens
• esophageal(cca.4-20s)
2018. 09. 16.
![Page 47: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/47.jpg)
Dysphagia
Difficultyin• oralpreparation• oral,pharyngealandesophagealtransport.
• Symptoms• aspiration(pre-,intra-,postdeglutitive)
• withoutcoughing(silent)–neurogeniccause• slowchewing,swallowing• difficultyinforwardingthebolus• coughing• hoarsenessduringmeals(„wetvoice”)• weightloss• feverwithoutanyobviouscause
2018. 09. 16.
Mészáros-Hacki
![Page 48: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/48.jpg)
Possible causes
• neurogenic• stroke• Parkinson’sdisease• ALS• multiplesclerosis• ICmalignancy• trauma• myastheniagr.,• toxicneuropathy,n.VII.paresis)
• local,organic• URTI• GOR• iatrogenic(intubation,laryngomicroscopy,irradiation)
• goiter,Zenker-div.• necktrauma• headandnecktu.
• psychogenic
2018. 09. 16.
![Page 49: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/49.jpg)
Examinations I.
• Generalexaminations• motoricfunction• breathing,phonation,articulation• ENTexamination• sluggishtonguemovement,salivation,foodremnantsintheoralcavity
• sensorytestoftheoralcavity,pharynx• muscletone• endoscopy
• velapharyngealclosure• garatizmokmozgása• szupraglottikus-,glottikuszár• colouredfoodinvarioussizesandviscosity
• esophagoscopy,pHmeasuring,esophagealmanometry,EMG
2018. 09. 16.
Mészáros-Hacki
![Page 50: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/50.jpg)
Examination – X-ray
• esophagealphase• amountofaspiratedfluid• diagnosisbylocation
• Salivaaspirationcannotbeassessed
2018. 09. 16.
![Page 51: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/51.jpg)
Az aspiráció súlyossági fokozatai
I. megtartottköhögésireflex,alkalmankéntaspirálII. megtartottköhögésireflex,permanensaspirációv.alkalmankénti
aspirációköhögésireflexnélkül,dehatékonyakaratlagosköhögésselIII. permanensaspirációköhögésireflexnélkül,deeredményes
akaratlagosköhögésselIV. permanensaspirációköhögésireflexnélkül,ineffektívakaratlagos
köhögéssel
2018. 09. 16. (Schröter-Morasch)
![Page 52: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/52.jpg)
Presbyphagy
• Causes• deformityofthecervicalspine• stroke• toothloss• deteriorationofsmelling• drymucosa• izomtevékenységgyengülése• bolusretencióaszájüregben,valleculakban,sin.piriformisban
• Treatingmethods• coldorhotmeals• seasoning• forcedswallowingtechnique
2018. 09. 16.
Mészáros-Hacki
![Page 53: Benign lesions of the larynx – swallowing disorders€¦ · Benign lesions of the larynx – swallowing disorders Semmelweis University Dept. of Otorhinolaryngology Head and Neck](https://reader034.vdocument.in/reader034/viewer/2022042403/5f1837e0fb7e8b1a2a5f177f/html5/thumbnails/53.jpg)
Dysphagia Functional Therapy (DFT)• Restitutional-causaltherapy
• breathing(intendedglotticclosureandcoughing)• improvingtheorofacialregion’sfunction
• muscletone• cold,sourmaterials(tongue,buccalregion)• chewingpractices• keepingthelarynxinelevatedposition(Mendelsohn’smaneuver)
• Compensatoryswallowing• changingthepositionofthehead
• forward–afterepiglottectomy• rotationtowardstheaffectedside–paresisn.rec.• backwards–injuredtonguemotility
• varietyofswallowingtechniqes• forced• frequent• ...
• Adaptationmethods(oralprostheses,specialglas,NOstraw!)• Diet(temperature,consistency,energy...)
2018. 09. 16.
Mészáros-Hacki