The physiologic and the pathologic swallowing process

It is estimated that 5 million people in Germany currently suffer from swallowing disorders. Due to increasing life expectancy and the good outcome of very premature infants, this number is expected to increase. Swallowing normally occurs in four phases, and for each phase there are diagnostic tools to assess whether the problem is anatomic-organic or functional. A detailed case history is followed by clinical examination of the cranial nerves, the orofacial region, the swallowing reflex, and pharyngeal and esophageal transit. Attention is also paid to age-related changes in the swallowing process, nasal regurgitation, retention at the base of the tongue or in the hypopharynx, and signs of aspiration.