Oropharyngeale Dysphagien – ein Update Teil 2: Ätiologie und Therapie

Zusammenfassung

Oropharyngeale Dysphagien haben eine hohe Prävalenz – vor allem bei alten Menschen. Differenzialdiagnostisch kommen viele Ursachen, wie z. B. neurologische Erkrankungen, Veränderungen an der Halswirbelsäule, bösartige Tumore im Kopf-Halsbereich, Begleiterscheinungen nach Tumortherapie, Nebenwirkung von Medikamenten sowie altersbedingte Schluckstörungen in Frage. Neben daraus resultierenden Einschränkungen in der Nahrungsaufnahme von bestimmten Konsistenzen können sich auch schwerwiegende Folgen, wie z. B. eine komplette nicht-orale Ernährung über eine PEG oder bei Speichelaspiration das Tragen einer geblockten Kanüle ergeben. Eine therapiesteuernde Diagnostik ist erforderlich, um die geeignete Behandlungsform zu finden, die häufig interdisziplinäre Aspekte beinhaltet.

Abstract

Update Oropharyngeal Dysphagia Part 2: Etiology and Therapy

Oropharyngeal dysphagia is a common problem, especially in the elderly. There is a wide range of causes: neurological disorders (such as stroke), osteophytes of the cervical spine, malignancies of the head and neck, as a consequence of radiotherapy or side effect from medication or simply "dysphagia of aging". Where oral feeding is sufficiently impaired then this route may have to be bypassed by percutaneous enteral gastrostomy. When aspiration is a risk, then a cuffed tracheostomy tube may be required. Individual needs must be addressed, usually, and best, by a multidisciplinary team.

Schlüsselwörter

Schlucken - Dysphagie - Aspiration - Schlucktherapie

Keywords

swallowing - dysphgia - aspiration - therapy of dysphagia

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