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Erschienen in: InFo Neurologie + Psychiatrie 3/2019

21.03.2019 | Aspiration | zertifizierte fortbildung

Moderne Diagnostik und Therapie von Schluckstörungen

Dysphagiemanagement verbessert Lebensqualität und senkt Mortalität

verfasst von: Dr. med. Bendix Labeit, Dr. med. Paul Muhle, Prof. Dr. med. Tobias Warnecke, Prof. Dr. med. Rainer Dziewas

Erschienen in: InFo Neurologie + Psychiatrie | Ausgabe 3/2019

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Zusammenfassung

Schluckstörungen haben bei nahezu allen neurologischen Erkrankungen eine hohe Prävalenz. Sie führen neben Mangelernährung und Dehydration zu schwerwiegenden Komplikationen wie Aspirationspneumonie, die eine der häufigsten Todesursachen bei neurologischen Patienten darstellt. Ein frühzeitiges Dysphagiemanagement verbessert deshalb nicht nur die Lebensqualität der Patienten entscheidend, sondern senkt die Mortalität. Dieser Artikel gibt eine Übersicht diagnostischer und therapeutischer Verfahren der neurogenen Dysphagie und soll somit die klinische Entscheidungsfindung erleichtern.
Literatur
1.
Zurück zum Zitat Jean A. Brain stem control of swallowing: Neuronal network and cellular mechanisms. Physiol Rev 2001; 81(2):929–69PubMedCrossRef Jean A. Brain stem control of swallowing: Neuronal network and cellular mechanisms. Physiol Rev 2001; 81(2):929–69PubMedCrossRef
2.
Zurück zum Zitat Teismann IK, Dziewas R, Steinstraeter O, Pantev C. Time-dependent hemispheric shift of the cortical control of volitional swallowing. Hum Brain Mapp 2009; 30(1):92–100PubMedCrossRef Teismann IK, Dziewas R, Steinstraeter O, Pantev C. Time-dependent hemispheric shift of the cortical control of volitional swallowing. Hum Brain Mapp 2009; 30(1):92–100PubMedCrossRef
3.
Zurück zum Zitat Martin RE, Goodyear BG, Gati JS, Menon RS. Cerebral cortical representation of automatic and volitional swallowing in humans. J Neurophysiol 2001; 85(2):938–50PubMedCrossRef Martin RE, Goodyear BG, Gati JS, Menon RS. Cerebral cortical representation of automatic and volitional swallowing in humans. J Neurophysiol 2001; 85(2):938–50PubMedCrossRef
4.
Zurück zum Zitat Hamdy S, Mikulis DJ, Crawley A, Xue S, Lau H, Henry S et al. Cortical activation during human volitional swallowing: An event-related fMRI study. Am J Physiol 1999; 277(1):G219–25PubMed Hamdy S, Mikulis DJ, Crawley A, Xue S, Lau H, Henry S et al. Cortical activation during human volitional swallowing: An event-related fMRI study. Am J Physiol 1999; 277(1):G219–25PubMed
5.
Zurück zum Zitat Hamdy S, Aziz Q, Rothwell JC, Singh KD, Barlow J, Hughes DG et al. The cortical topography of human swallowing musculature in health and disease. Nat Med 1996; 2(11):1217–24PubMedCrossRef Hamdy S, Aziz Q, Rothwell JC, Singh KD, Barlow J, Hughes DG et al. The cortical topography of human swallowing musculature in health and disease. Nat Med 1996; 2(11):1217–24PubMedCrossRef
6.
Zurück zum Zitat Furlong PL, Hobson AR, Aziz Q, Barnes GR, Singh KD, Hillebrand A et al. Dissociating the spatio-temporal characteristics of cortical neuronal activity associated with human volitional swallowing in the healthy adult brain. Neuroimage 2004; 22(4):1447–55PubMedCrossRef Furlong PL, Hobson AR, Aziz Q, Barnes GR, Singh KD, Hillebrand A et al. Dissociating the spatio-temporal characteristics of cortical neuronal activity associated with human volitional swallowing in the healthy adult brain. Neuroimage 2004; 22(4):1447–55PubMedCrossRef
7.
Zurück zum Zitat Dziewas R, Soros P, Ishii R, Chau W, Henningsen H, Ringelstein EB et al. Neuroimaging evidence for cortical involvement in the preparation and in the act of swallowing. Neuroimage 2003; 20(1):135–44PubMedCrossRef Dziewas R, Soros P, Ishii R, Chau W, Henningsen H, Ringelstein EB et al. Neuroimaging evidence for cortical involvement in the preparation and in the act of swallowing. Neuroimage 2003; 20(1):135–44PubMedCrossRef
8.
Zurück zum Zitat Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: Incidence, diagnosis, and pulmonary complications. Stroke 2005 Dec;36(12):2756–63PubMedCrossRef Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: Incidence, diagnosis, and pulmonary complications. Stroke 2005 Dec;36(12):2756–63PubMedCrossRef
9.
Zurück zum Zitat Flowers HL, Skoretz SA, Streiner DL, Silver FL, Martino R. MRI-based neuroanatomical predictors of dysphagia after acute ischemic stroke: A systematic review and meta-analysis. Cerebrovasc Dis. 2011;32(1):1–10PubMedCrossRef Flowers HL, Skoretz SA, Streiner DL, Silver FL, Martino R. MRI-based neuroanatomical predictors of dysphagia after acute ischemic stroke: A systematic review and meta-analysis. Cerebrovasc Dis. 2011;32(1):1–10PubMedCrossRef
10.
Zurück zum Zitat Joundi RA, Martino R, Saposnik G, Giannakeas V, Fang J, Kapral MK. Predictors and Outcomes of Dysphagia Screening After Acute Ischemic Stroke. Stroke 2017; 48(4):900–6PubMedCrossRef Joundi RA, Martino R, Saposnik G, Giannakeas V, Fang J, Kapral MK. Predictors and Outcomes of Dysphagia Screening After Acute Ischemic Stroke. Stroke 2017; 48(4):900–6PubMedCrossRef
11.
Zurück zum Zitat Smithard DG, Smeeton NC, Wolfe CDA. Long-term outcome after stroke: Does dysphagia matter? Age Ageing 2007; 36(1):90–4PubMedCrossRef Smithard DG, Smeeton NC, Wolfe CDA. Long-term outcome after stroke: Does dysphagia matter? Age Ageing 2007; 36(1):90–4PubMedCrossRef
12.
Zurück zum Zitat Teasell R, Foley N, Fisher J, Finestone H. The incidence, management, and complications of dysphagia in patients with medullary strokes admitted to a rehabilitation unit. Dysphagia 2002; 17(2):115–20PubMedCrossRef Teasell R, Foley N, Fisher J, Finestone H. The incidence, management, and complications of dysphagia in patients with medullary strokes admitted to a rehabilitation unit. Dysphagia 2002; 17(2):115–20PubMedCrossRef
13.
Zurück zum Zitat Suntrup-Krueger S, Minnerup J, Muhle P, Claus I, Schroder JB, Marian T et al. The Effect of Improved Dysphagia Care on Outcome in Patients with Acute Stroke: Trends from 8-Year Data of a Large Stroke Register. Cerebrovasc Dis 2018; 45(3-4):101–8PubMedCrossRef Suntrup-Krueger S, Minnerup J, Muhle P, Claus I, Schroder JB, Marian T et al. The Effect of Improved Dysphagia Care on Outcome in Patients with Acute Stroke: Trends from 8-Year Data of a Large Stroke Register. Cerebrovasc Dis 2018; 45(3-4):101–8PubMedCrossRef
14.
Zurück zum Zitat Grube MM, Koennecke H-C, Walter G, Meisel A, Sobesky J, Nolte CH et al. Influence of acute complications on outcome 3 months after ischemic stroke. PLoS One 2013; 8(9):e75719PubMedPubMedCentralCrossRef Grube MM, Koennecke H-C, Walter G, Meisel A, Sobesky J, Nolte CH et al. Influence of acute complications on outcome 3 months after ischemic stroke. PLoS One 2013; 8(9):e75719PubMedPubMedCentralCrossRef
15.
Zurück zum Zitat Bray BD, Smith CJ, Cloud GC, Enderby P, James M, Paley L et al. The association between delays in screening for and assessing dysphagia after acute stroke, and the risk of stroke-associated pneumonia. J Neurol Neurosurg Psychiatry 2017; 88(1):25–30PubMedCrossRef Bray BD, Smith CJ, Cloud GC, Enderby P, James M, Paley L et al. The association between delays in screening for and assessing dysphagia after acute stroke, and the risk of stroke-associated pneumonia. J Neurol Neurosurg Psychiatry 2017; 88(1):25–30PubMedCrossRef
16.
Zurück zum Zitat Morgan AS, Mackay LE. Causes and complications associated with swallowing disorders in traumatic brain injury. J Head Trauma Rehabil 1999; 14(5):454–61PubMedCrossRef Morgan AS, Mackay LE. Causes and complications associated with swallowing disorders in traumatic brain injury. J Head Trauma Rehabil 1999; 14(5):454–61PubMedCrossRef
17.
Zurück zum Zitat Kalf JG, Swart BJM de, Bloem BR, Munneke M. Prevalence of oropharyngeal dysphagia in Parkinson’s disease: A meta-analysis. Parkinsonism Relat Disord 2012; 18(4):311–5PubMedCrossRef Kalf JG, Swart BJM de, Bloem BR, Munneke M. Prevalence of oropharyngeal dysphagia in Parkinson’s disease: A meta-analysis. Parkinsonism Relat Disord 2012; 18(4):311–5PubMedCrossRef
18.
Zurück zum Zitat Fasano A, Visanji NP, Liu LWC, Lang AE, Pfeiffer RF. Gastrointestinal dysfunction in Parkinson’s disease. Lancet Neurol 2015; 14(6):625–39PubMedCrossRef Fasano A, Visanji NP, Liu LWC, Lang AE, Pfeiffer RF. Gastrointestinal dysfunction in Parkinson’s disease. Lancet Neurol 2015; 14(6):625–39PubMedCrossRef
19.
Zurück zum Zitat Langmore SE, Olney RK, Lomen-Hoerth C, Miller BL. Dysphagia in patients with frontotemporal lobar dementia. Arch Neurol 2007; 64(1):58–62PubMedCrossRef Langmore SE, Olney RK, Lomen-Hoerth C, Miller BL. Dysphagia in patients with frontotemporal lobar dementia. Arch Neurol 2007; 64(1):58–62PubMedCrossRef
20.
Zurück zum Zitat Suh MK, Kim H, Na DL. Dysphagia in patients with dementia: Alzheimer versus vascular. Alzheimer Dis Assoc Disord 2009; 23(2):178–84PubMedCrossRef Suh MK, Kim H, Na DL. Dysphagia in patients with dementia: Alzheimer versus vascular. Alzheimer Dis Assoc Disord 2009; 23(2):178–84PubMedCrossRef
21.
Zurück zum Zitat Kuhnlein P, Gdynia H-J, Sperfeld A-D, Lindner-Pfleghar B, Ludolph AC, Prosiegel M et al. Diagnosis and treatment of bulbar symptoms in amyotrophic lateral sclerosis. Nat Clin Pract Neurol 2008; 4(7):366–74PubMedCrossRef Kuhnlein P, Gdynia H-J, Sperfeld A-D, Lindner-Pfleghar B, Ludolph AC, Prosiegel M et al. Diagnosis and treatment of bulbar symptoms in amyotrophic lateral sclerosis. Nat Clin Pract Neurol 2008; 4(7):366–74PubMedCrossRef
22.
Zurück zum Zitat Guan X-L, Wang H, Huang H-S, Meng L. Prevalence of dysphagia in multiple sclerosis: A systematic review and meta-analysis. Italy; 2015 May. Guan X-L, Wang H, Huang H-S, Meng L. Prevalence of dysphagia in multiple sclerosis: A systematic review and meta-analysis. Italy; 2015 May.
23.
Zurück zum Zitat Grob D, Arsura EL, Brunner NG, Namba T. The course of myasthenia gravis and therapies affecting outcome. Ann N Y Acad Sci 1987; 505:472–99.PubMedCrossRef Grob D, Arsura EL, Brunner NG, Namba T. The course of myasthenia gravis and therapies affecting outcome. Ann N Y Acad Sci 1987; 505:472–99.PubMedCrossRef
24.
Zurück zum Zitat Langdon PC, Mulcahy K, Shepherd KL, Low VH, Mastaglia FL. Pharyngeal dysphagia in inflammatory muscle diseases resulting from impaired suprahyoid musculature. Dysphagia 2012; 27(3):408–17PubMedCrossRef Langdon PC, Mulcahy K, Shepherd KL, Low VH, Mastaglia FL. Pharyngeal dysphagia in inflammatory muscle diseases resulting from impaired suprahyoid musculature. Dysphagia 2012; 27(3):408–17PubMedCrossRef
25.
Zurück zum Zitat Mulcahy KP, Langdon PC, Mastaglia F. Dysphagia in inflammatory myopathy: Self-report, incidence, and prevalence. Dysphagia 2012; 27(1):64–9PubMedCrossRef Mulcahy KP, Langdon PC, Mastaglia F. Dysphagia in inflammatory myopathy: Self-report, incidence, and prevalence. Dysphagia 2012; 27(1):64–9PubMedCrossRef
26.
Zurück zum Zitat Oh TH, Brumfield KA, Hoskin TL, Stolp KA, Murray JA, Bassford JR. Dysphagia in inflammatory myopathy: Clinical characteristics, treatment strategies, and outcome in 62 patients. Mayo Clin Proc 2007; 82(4):441–7PubMedCrossRef Oh TH, Brumfield KA, Hoskin TL, Stolp KA, Murray JA, Bassford JR. Dysphagia in inflammatory myopathy: Clinical characteristics, treatment strategies, and outcome in 62 patients. Mayo Clin Proc 2007; 82(4):441–7PubMedCrossRef
27.
Zurück zum Zitat Lynn SJ, Sawyers SM, Moller PW, O’Donnell JL, Chapman PT. Adult-onset inflammatory myopathy: North Canterbury experience 1989-2001. Intern Med J 2005; 35(3):170–3PubMedCrossRef Lynn SJ, Sawyers SM, Moller PW, O’Donnell JL, Chapman PT. Adult-onset inflammatory myopathy: North Canterbury experience 1989-2001. Intern Med J 2005; 35(3):170–3PubMedCrossRef
28.
Zurück zum Zitat Tolep K, Getch CL, Criner GJ. Swallowing dysfunction in patients receiving prolonged mechanical ventilation. Chest 1996; 109(1):167–72PubMedCrossRef Tolep K, Getch CL, Criner GJ. Swallowing dysfunction in patients receiving prolonged mechanical ventilation. Chest 1996; 109(1):167–72PubMedCrossRef
29.
Zurück zum Zitat Macht M, Wimbish T, Clark BJ, Benson AB, Burnham EL, Williams A et al. Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. Crit Care 2011; 15(5):R231PubMedPubMedCentralCrossRef Macht M, Wimbish T, Clark BJ, Benson AB, Burnham EL, Williams A et al. Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. Crit Care 2011; 15(5):R231PubMedPubMedCentralCrossRef
30.
Zurück zum Zitat Suiter DM, Leder SB. Clinical utility of the 3-ounce water swallow test. Dysphagia 2008; 23(3):244–50PubMedCrossRef Suiter DM, Leder SB. Clinical utility of the 3-ounce water swallow test. Dysphagia 2008; 23(3):244–50PubMedCrossRef
31.
Zurück zum Zitat Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A et al. Dysphagia bedside screening for acute-stroke patients: The Gugging Swallowing Screen. Stroke 2007; 38(11):2948–52PubMedCrossRef Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A et al. Dysphagia bedside screening for acute-stroke patients: The Gugging Swallowing Screen. Stroke 2007; 38(11):2948–52PubMedCrossRef
32.
Zurück zum Zitat Warnecke T, Teismann I, Meimann W, Olenberg S, Zimmermann J, Kramer C et al. Assessment of aspiration risk in acute ischaemic stroke—evaluation of the simple swallowing provocation test. J Neurol Neurosurg Psychiatry 2008; 79(3):312–4PubMedCrossRef Warnecke T, Teismann I, Meimann W, Olenberg S, Zimmermann J, Kramer C et al. Assessment of aspiration risk in acute ischaemic stroke—evaluation of the simple swallowing provocation test. J Neurol Neurosurg Psychiatry 2008; 79(3):312–4PubMedCrossRef
33.
Zurück zum Zitat Labeit B, Mueller H, Muhle P, Claus I, Warnecke T, Dziewas R et al. Predicting Dysphagia with National Institute of Health Stroke Scale: Distinction between Infra- and Supratentorial Region is Essential. Cerebrovasc Dis 2018; 46(3-4):152–60PubMedCrossRef Labeit B, Mueller H, Muhle P, Claus I, Warnecke T, Dziewas R et al. Predicting Dysphagia with National Institute of Health Stroke Scale: Distinction between Infra- and Supratentorial Region is Essential. Cerebrovasc Dis 2018; 46(3-4):152–60PubMedCrossRef
34.
Zurück zum Zitat Schiele JT, Penner H, Schneider H, Quinzler R, Reich G, Wezler N et al. Swallowing Tablets and Capsules Increases the Risk of Penetration and Aspiration in Patients with Stroke-Induced Dysphagia. Dysphagia 2015; 30(5):571–82PubMedCrossRef Schiele JT, Penner H, Schneider H, Quinzler R, Reich G, Wezler N et al. Swallowing Tablets and Capsules Increases the Risk of Penetration and Aspiration in Patients with Stroke-Induced Dysphagia. Dysphagia 2015; 30(5):571–82PubMedCrossRef
35.
Zurück zum Zitat Flader CM, Rosendahl C, Günther T. Leitlinienkonforme Dysphagiediagnostik Eine repräsentative Befragung von Logopäden an zertifizierten Stroke-Units. Nervenarzt 2017; (88):1168–76 Flader CM, Rosendahl C, Günther T. Leitlinienkonforme Dysphagiediagnostik Eine repräsentative Befragung von Logopäden an zertifizierten Stroke-Units. Nervenarzt 2017; (88):1168–76
36.
Zurück zum Zitat Dziewas R, Glahn J, Helfer C, Ickenstein G, Keller J, Lapa S et al. FEES for neurogenic dysphagia: Training curriculum of the German Society of Neurology and the German Stroke Society. Nervenarzt 2014; 85(8):1006–15PubMedCrossRef Dziewas R, Glahn J, Helfer C, Ickenstein G, Keller J, Lapa S et al. FEES for neurogenic dysphagia: Training curriculum of the German Society of Neurology and the German Stroke Society. Nervenarzt 2014; 85(8):1006–15PubMedCrossRef
37.
Zurück zum Zitat Warnecke T, Suntrup S, Teismann IK, Hamacher C, Oelenberg S, Dziewas R. Standardized endoscopic swallowing evaluation for tracheostomy decannulation in critically ill neurologic patients. Crit Care Med 2013; 41(7):1728–32PubMedCrossRef Warnecke T, Suntrup S, Teismann IK, Hamacher C, Oelenberg S, Dziewas R. Standardized endoscopic swallowing evaluation for tracheostomy decannulation in critically ill neurologic patients. Crit Care Med 2013; 41(7):1728–32PubMedCrossRef
38.
Zurück zum Zitat Logemann JA. Manual for the videofluorographic study of swallowing. Austin, Tex.: PRO-ED; 1991 Logemann JA. Manual for the videofluorographic study of swallowing. Austin, Tex.: PRO-ED; 1991
39.
Zurück zum Zitat Prosiegel M, Heintze M, Wagner-Sonntag E, Hannig C, Wuttge-Hannig A, Yassouridis A. Deglutition disorders in neurological patients. A prospective study of diagnosis, pattern of impairment, therapy and outcome. Nervenarzt 2002; 73(4):364–70PubMed Prosiegel M, Heintze M, Wagner-Sonntag E, Hannig C, Wuttge-Hannig A, Yassouridis A. Deglutition disorders in neurological patients. A prospective study of diagnosis, pattern of impairment, therapy and outcome. Nervenarzt 2002; 73(4):364–70PubMed
40.
Zurück zum Zitat Prosiegel M, Holing R, Heintze M, Wagner-Sonntag E, Wiseman K. Swallowing therapy—a prospective study on patients with neurogenic dysphagia due to unilateral paresis of the vagal nerve, Avellis’ syndrome, Wallenberg’s syndrome, posterior fossa tumours and cerebellar hemorrhage. Acta Neurochir Suppl 2005; 93:35–7PubMedCrossRef Prosiegel M, Holing R, Heintze M, Wagner-Sonntag E, Wiseman K. Swallowing therapy—a prospective study on patients with neurogenic dysphagia due to unilateral paresis of the vagal nerve, Avellis’ syndrome, Wallenberg’s syndrome, posterior fossa tumours and cerebellar hemorrhage. Acta Neurochir Suppl 2005; 93:35–7PubMedCrossRef
41.
Zurück zum Zitat Nusser-Müller-Busch R, Coombes K. Die Therapie des Facio-Oralen Trakts: F.O.T.T. nach Kay Coombes. 4. Auflage 2015. Berlin: Springer; 2015.CrossRef Nusser-Müller-Busch R, Coombes K. Die Therapie des Facio-Oralen Trakts: F.O.T.T. nach Kay Coombes. 4. Auflage 2015. Berlin: Springer; 2015.CrossRef
42.
Zurück zum Zitat Seidl RO, Nusser-Muller-Busch R, Hollweg W, Westhofen M, Ernst A. Pilot study of a neurophysiological dysphagia therapy for neurological patients. Clin Rehabil 2007; 21(8):686–97.PubMedCrossRef Seidl RO, Nusser-Muller-Busch R, Hollweg W, Westhofen M, Ernst A. Pilot study of a neurophysiological dysphagia therapy for neurological patients. Clin Rehabil 2007; 21(8):686–97.PubMedCrossRef
43.
Zurück zum Zitat Shaker R, Easterling C, Kern M, Nitschke T, Massey B, Daniels S et al. Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening. Gastroenterology 2002; 122(5):1314–21PubMedCrossRef Shaker R, Easterling C, Kern M, Nitschke T, Massey B, Daniels S et al. Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening. Gastroenterology 2002; 122(5):1314–21PubMedCrossRef
44.
Zurück zum Zitat Lazzara G, Lazarus C, Logemann JA. Impact of thermal stimulation on the triggering of the swallowing reflex. Dysphagia 1986; 2(1):73–7CrossRef Lazzara G, Lazarus C, Logemann JA. Impact of thermal stimulation on the triggering of the swallowing reflex. Dysphagia 1986; 2(1):73–7CrossRef
45.
Zurück zum Zitat Hwang CH, Choi KH, Ko YS, Leem CM. Pre-emptive swallowing stimulation in long-term intubated patients. Clin Rehabil 2007; 21(1):41–6PubMedCrossRef Hwang CH, Choi KH, Ko YS, Leem CM. Pre-emptive swallowing stimulation in long-term intubated patients. Clin Rehabil 2007; 21(1):41–6PubMedCrossRef
46.
Zurück zum Zitat Shanahan TK, Logemann JA, Rademaker AW, Pauloski BR, Kahrilas PJ. Chin-down posture effect on aspiration in dysphagic patients. Arch Phys Med Rehabil 1993; 74(7):736–9PubMedCrossRef Shanahan TK, Logemann JA, Rademaker AW, Pauloski BR, Kahrilas PJ. Chin-down posture effect on aspiration in dysphagic patients. Arch Phys Med Rehabil 1993; 74(7):736–9PubMedCrossRef
47.
Zurück zum Zitat Terre R, Mearin F. Effectiveness of chin-down posture to prevent tracheal aspiration in dysphagia secondary to acquired brain injury. A videofluoroscopy study. Neurogastroenterol Motil 2012; 24(5):414–9, e206.PubMedCrossRef Terre R, Mearin F. Effectiveness of chin-down posture to prevent tracheal aspiration in dysphagia secondary to acquired brain injury. A videofluoroscopy study. Neurogastroenterol Motil 2012; 24(5):414–9, e206.PubMedCrossRef
48.
Zurück zum Zitat Logemann JA, Kahrilas PJ, Kobara M, Vakil NB. The benefit of head rotation on pharyngoesophageal dysphagia. Arch Phys Med Rehabil 1989; 70(10):767–71PubMed Logemann JA, Kahrilas PJ, Kobara M, Vakil NB. The benefit of head rotation on pharyngoesophageal dysphagia. Arch Phys Med Rehabil 1989; 70(10):767–71PubMed
49.
Zurück zum Zitat Bulow M, Olsson R, Ekberg O. Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in patients with pharyngeal dysfunction. Dysphagia 2001; 16(3):190–5PubMedCrossRef Bulow M, Olsson R, Ekberg O. Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in patients with pharyngeal dysfunction. Dysphagia 2001; 16(3):190–5PubMedCrossRef
50.
Zurück zum Zitat Bhattacharyya N, Kotz T, Shapiro J. The effect of bolus consistency on dysphagia in unilateral vocal cord paralysis. Otolaryngol Head Neck Surg 2003; 129(6):632–6PubMedCrossRef Bhattacharyya N, Kotz T, Shapiro J. The effect of bolus consistency on dysphagia in unilateral vocal cord paralysis. Otolaryngol Head Neck Surg 2003; 129(6):632–6PubMedCrossRef
51.
Zurück zum Zitat Clave P, Kraa M de, Arreola V, Girvent M, Farre R, Palomera E et al. The effect of bolus viscosity on swallowing function in neurogenic dysphagia. Aliment Pharmacol Ther 2006; 24(9):1385–94PubMedCrossRef Clave P, Kraa M de, Arreola V, Girvent M, Farre R, Palomera E et al. The effect of bolus viscosity on swallowing function in neurogenic dysphagia. Aliment Pharmacol Ther 2006; 24(9):1385–94PubMedCrossRef
52.
Zurück zum Zitat Nagaya M, Kachi T, Yamada T, Sumi Y. Videofluorographic observations on swallowing in patients with dysphagia due to neurodegenerative diseases. Nagoya J Med Sci 2004; 67(1-2):17–23PubMed Nagaya M, Kachi T, Yamada T, Sumi Y. Videofluorographic observations on swallowing in patients with dysphagia due to neurodegenerative diseases. Nagoya J Med Sci 2004; 67(1-2):17–23PubMed
53.
Zurück zum Zitat Steele CM, Alsanei WA, Ayanikalath S, Barbon CEA, Chen J, Cichero JA et al. The influence of food texture and liquid consistency modification on swallowing physiology and function: A systematic review. Dysphagia 2015 Feb;30(1):2–26PubMedCrossRef Steele CM, Alsanei WA, Ayanikalath S, Barbon CEA, Chen J, Cichero JA et al. The influence of food texture and liquid consistency modification on swallowing physiology and function: A systematic review. Dysphagia 2015 Feb;30(1):2–26PubMedCrossRef
54.
Zurück zum Zitat Newman R, Vilardell N, Clave P, Speyer R. Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD). Dysphagia 2016 Apr;31(2):232–49PubMedPubMedCentralCrossRef Newman R, Vilardell N, Clave P, Speyer R. Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD). Dysphagia 2016 Apr;31(2):232–49PubMedPubMedCentralCrossRef
55.
Zurück zum Zitat Laciuga H, Rosenbek JC, Davenport PW, Sapienza CM. Functional outcomes associated with expiratory muscle strength training: Narrative review. J Rehabil Res Dev 2014; 51(4):535–46PubMedCrossRef Laciuga H, Rosenbek JC, Davenport PW, Sapienza CM. Functional outcomes associated with expiratory muscle strength training: Narrative review. J Rehabil Res Dev 2014; 51(4):535–46PubMedCrossRef
56.
Zurück zum Zitat Nakagawa T, Wada H, Sekizawa K, Arai H, Sasaki H. Amantadine and pneumonia. Lancet 1999; 353(9159):1157PubMedCrossRef Nakagawa T, Wada H, Sekizawa K, Arai H, Sasaki H. Amantadine and pneumonia. Lancet 1999; 353(9159):1157PubMedCrossRef
57.
Zurück zum Zitat Kobayashi H, Nakagawa T, Sekizawa K, Arai H, Sasaki H. Levodopa and swallowing reflex. Lancet 1996; 348(9037):1320–1PubMedCrossRef Kobayashi H, Nakagawa T, Sekizawa K, Arai H, Sasaki H. Levodopa and swallowing reflex. Lancet 1996; 348(9037):1320–1PubMedCrossRef
58.
Zurück zum Zitat Caldeira D, Alarcao J, Vaz-Carneiro A, Costa J. Risk of pneumonia associated with use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers: Systematic review and meta-analysis. BMJ. 2012 Jul 11;345:e4260.PubMedPubMedCentralCrossRef Caldeira D, Alarcao J, Vaz-Carneiro A, Costa J. Risk of pneumonia associated with use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers: Systematic review and meta-analysis. BMJ. 2012 Jul 11;345:e4260.PubMedPubMedCentralCrossRef
59.
Zurück zum Zitat Lee JSW, Chui PY, Ma HM, Auyeung TW, Kng C, Law T et al. Does Low Dose Angiotensin Converting Enzyme Inhibitor Prevent Pneumonia in Older People With Neurologic Dysphagia—A Randomized Placebo-Controlled Trial. J Am Med Dir Assoc 2015; 16(8):702–7PubMedCrossRef Lee JSW, Chui PY, Ma HM, Auyeung TW, Kng C, Law T et al. Does Low Dose Angiotensin Converting Enzyme Inhibitor Prevent Pneumonia in Older People With Neurologic Dysphagia—A Randomized Placebo-Controlled Trial. J Am Med Dir Assoc 2015; 16(8):702–7PubMedCrossRef
60.
Zurück zum Zitat Ebihara T, Takahashi H, Ebihara S, Okazaki T, Sasaki T, Watando A et al. Capsaicin troche for swallowing dysfunction in older people. J Am Geriatr Soc 2005; 53(5):824–8PubMedCrossRef Ebihara T, Takahashi H, Ebihara S, Okazaki T, Sasaki T, Watando A et al. Capsaicin troche for swallowing dysfunction in older people. J Am Geriatr Soc 2005; 53(5):824–8PubMedCrossRef
61.
Zurück zum Zitat Ortega O, Rofes L, Martin A, Arreola V, Lopez I, Clave P. A Comparative Study Between Two Sensory Stimulation Strategies After Two Weeks Treatment on Older Patients with Oropharyngeal Dysphagia. Dysphagia 2016; 31(5):706–16PubMedCrossRef Ortega O, Rofes L, Martin A, Arreola V, Lopez I, Clave P. A Comparative Study Between Two Sensory Stimulation Strategies After Two Weeks Treatment on Older Patients with Oropharyngeal Dysphagia. Dysphagia 2016; 31(5):706–16PubMedCrossRef
62.
Zurück zum Zitat Singh K, Marquez-Lara A, Nandyala SV, Patel AA, Fineberg SJ. Incidence and risk factors for dysphagia after anterior cervical fusion. Spine (Phila Pa 1976) 2013; 38(21):1820–5CrossRef Singh K, Marquez-Lara A, Nandyala SV, Patel AA, Fineberg SJ. Incidence and risk factors for dysphagia after anterior cervical fusion. Spine (Phila Pa 1976) 2013; 38(21):1820–5CrossRef
63.
Zurück zum Zitat Warnecke T, Dziewas R. Neurogene Dysphagien Diagnostik und Therapie 2. Auflage. Stuttgart: Kohlhammer; 2018 Warnecke T, Dziewas R. Neurogene Dysphagien Diagnostik und Therapie 2. Auflage. Stuttgart: Kohlhammer; 2018
64.
Zurück zum Zitat Muhle P, Wirth R, Glahn J, Dziewas R. [Schluckstörungen im Alter. Physiologie und Pathophysiologie]. Der Nervenarzt 2015;86(4):440–51PubMedCrossRef Muhle P, Wirth R, Glahn J, Dziewas R. [Schluckstörungen im Alter. Physiologie und Pathophysiologie]. Der Nervenarzt 2015;86(4):440–51PubMedCrossRef
Metadaten
Titel
Moderne Diagnostik und Therapie von Schluckstörungen
Dysphagiemanagement verbessert Lebensqualität und senkt Mortalität
verfasst von
Dr. med. Bendix Labeit
Dr. med. Paul Muhle
Prof. Dr. med. Tobias Warnecke
Prof. Dr. med. Rainer Dziewas
Publikationsdatum
21.03.2019

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