Oropharyngeal Dysphagia Flashcards
What is Dysphagia?
Difficulty moving food/liquid through mouth, pharynx, esophagus
What will a patient sense with Dysphagia?
Swallowed material sticking along the path
When do Oropharyngeal Dysphagias occur?
At the beginning of swallowing
General symptoms and location of food sticking with Oropharyngeal Dysphagias
- Trouble initiating swallowing
- ENT symptoms, nasal regurgitation, aspiration
- Food sticks at level of suprasternal notch
3 common Oropharyngeal Dysphagias?
- Zenker’s Diverticulum
- Esophageal web
- Sjogren Syndrome
3 common Oropharyngeal Dysphagias?
- Zenker’s Diverticulum
- Esophageal web
- Sjogren Syndrome
What is Zenker’s Diverticulum?
False diverticula involving the mucosa/submucosa through the muscular layer of the posterior esophagus proximal to the cricopharyngeus (Killian’s triangle)
Posterior false diverticula?
Zenker’s Diverticulum
Zenker’s Diverticulum occurs at an area of weakness which is due to?
Loss of elasticity of upper esophageal sphincter
Zenker’s Diverticulum is constant or progressive?
Progressive!
Symptoms of Zenker’s Diverticulum
Coughing, throat discomfort
Halitosis and regurgitation
Choking, gurgling and palpable protrusion
Coughing and throat discomfort
- > Halitosis and regurgitation
- > Choking and palpable protrusion
Zenker’s Diverticulum
What test should you do and why for Zenker’s Diverticulum?
Barium Swallow BEFORE EGD due to risk of perforation
What test should you do and why for Zenker’s Diverticulum?
Barium Swallow BEFORE EGD due to risk of perforation
What are possible complications of Zenker’s Diverticulum?
Perforation (if EGD done before barium swallow)
Weight loss
Aspiration -> pneumonia and lung abscess
What is an Esophageal Web?
Thin membranes of squamous mucosa affecting the proximal or mid esophagus
Thin membranes of mucosa affecting the proximal or mid esophagus
Esophageal web
Esophageal web is constant or progressive?
Constant!
Symptoms of Esophageal web?
Intermittent dysphagia with solids
Esophageal web can be acquired due to what 2 things?
Eosinophilic esophagitis
Plummer Vision Syndrome
What is Plummer Vision Syndrome and what can it cause?
- Can cause an Esophageal web
= Iron deficient anemia, Koilonychia, glossitis and angular chelitis
Test and treatment for Esophageal web?
Barium Swallow
Dilation
What is Sjogren Syndrome?
Autoimmune disease - exocrine gland problem
Who does Sjogren Syndrome primarily affect?
Post menopausal females
Symptoms of Sjogren Syndrome?
Dry mouth (xerostomia) --> Oropharyngeal dysphagia Enlargement of salivary glands Dry eyes with sensation of foreign body
Keratoconjuctivitis sicca
Dry eyes with sensation of foreign body in them
- Seen with Sjogren Syndrome
Symptoms of Sjogren Syndrome?
Dry mouth (xerostomia) -> Oropharyngeal dysphagia Enlargement of salivary glands Dry eyes
What tests should be ordered for Sjogren Syndrome?
Minor salivary gland biopsy
- Tear/saliva production
What markers will be (+) with Sjogren Syndrome?
(+) Anti SSA/RO
(+) Anti SSB/LA
What are those with Sjogren Syndrome at an increased risk for developing?
Oral infections - Dental caries
B-cell NHL
