基礎的理論に基づいた嚥下障害診療

抄録

Swallowing is controlled by the neuronal circuitry in the brainstem through complex mechanisms involving coordinated sequential and patterned movements of swallowing-related muscles. Despite the complexity of the pathogenesis of swallowing impairments, patients with dysphagia should be treated based on the pathophysiology of the swallowing condition in individual patients. The pharyngeal stage of swallowing is triggered by visceral afferents in the larynx and pharynx and has sensorimotor feedback mechanisms which assist in the swallowing movements. Interferential current stimulation to the neck may help patients with dysphagia with delayed swallowing initiation. Laryngeal suspension surgery can help patients with impaired laryngeal excursion, while cricopharyngeal myotomy can help patients with incomplete opening of the esophageal inlet during pharyngeal swallowing. Rehabilitation and/or surgical intervention for dysphagia can be applied to patients with dysphagia and tailored to the functional disturbance of swallowing.