Oropharyngeal dysphagia and nutritional management

Abstract

The management of oropharyngeal dysphagia has received growing attention recently. Specialists from many disciplines are involved and the results of developments in dysphagia management are published in a range of journals. This review reports on recent developments in the diagnosis and clinical management of dysphagia. New instruments have been developed recently for diagnosis. Clinical observations have been made that promise to provide a better understanding of the various deficits involved. Deficiencies in both recognizing and managing dysphagia have been highlighted and recent reviews published. New techniques for quantifying the type and degree of dysphagia in patients are described. Prospective studies have emphasized that dysphagia frequently remains imperfectly diagnosed; some of these newer less expensive techniques may improve diagnosis. The benefits of using multidisciplinary teams for the effective management of dysphagia have been emphasized by a number of investigators. Quality of life issues in dysphagia are becoming more widely recognized and recommendations designed to improve patients' quality of life have been made, including improvements in nutrition and the use of psychological counselling. Cochrane Reviewers have identified shortcomings in the dysphagia knowledge base and have stressed the need for more properly controlled and randomized clinical trials.