Symposium: Dysphagia, Its Clinical and Basic Investigations Introduction

Abstract

A bolus passes through hypopharynx then to proceed to the entrance of esophagus where the second stage of deglutition commences.Should a bolus passes down to the larynx, one must investigate the cause of the trouble, and one can employ the various methods of study of dysphagia as follows.1. X-ray fluoroscopy with spot-photography.2. Cineradicgraphic investigation.3. Intra-luminal continuous pressure study.4. Electromyographic investigation of the muscles involved.5. Combination of electromyography and cineradiography.6. High speed, ninety flames or more, thirty-five mm cineradiography.7. Investigation of innervation by horse-radish method.One must use one or more of methods mentioned above to investigate dysphagia.X-ray examination with fluoroscopy and spot photography is the first step of whole studies. This can tell you much about the swallowing, and no one can go further study without X-ray fluoroscopy.Cineradiography in high speed i s far advantage for investigation of dysphagia because this speed of cineradiography can pick up the more precise motility of the esophagus than one can see by his bear eyes. For example, various kinds if irregular contractives can be picked up by this methods.It is worth while doing intra-luminal pressure study in various spots of esophagus to be measured, this can give further information about deglutition especially in second and third stages.Combination of electromyography and cineradiography has some limitation to its location though, this gives the most precise information about dysphagia.Horse-radish percxidase method has been applied for few years to lcalize the centers of all motor activities of fibers. This method should be carried cut more in future to determine the various centers of efferent fibers.The investigation of dysphagia depends upon the method of research mentioned above and one can choose whatever method he has in his own hand.One of the surgical treatments of dysphagia is to severe and cut the cricopharyngeus muscle fibers and thyropharyngeous muscle fibers. This is effective for the certain types of dysphagia though, on the other hand, one should observe what does a nature do for the treatment.