Neurolaryngological disorders and deglutition

Dysphagia and dysphonia are commonly associated with neuromuscular disorders. The symptoms and complications arise from the sensorimotor dysfunction of the oral and pharyngeal phases of swallowing. These symptoms may be unapparent due to compensation strategies, absent sensory cough reflex, or altered cognition. The risks of dysphagia are malnutrition, dehydration, and aspiration. Finding patients at risk is key to avoiding unnecessary complications. Dysphagia could be the first sign of a neuromuscular disease. Videoendoscopy, videofluoroscopy, manometric and electrophysiological studies are complementary tests and should be selected according to patient complaints and availability. In general, neuromuscular diseases tend to affect most phases of deglutition with variable expression and progression among patients. The association with old age of many degenerative conditions further impairs swallowing. Knowledge and awareness of neuromuscular diseases, the signs and symptoms that could affect speech and swallowing, along with familiarity performing a detailed neurological pharyngolaryngeal examination, is essential in understanding the mechanisms altering swallowing and in planning the best treatment. This chapter gives an overview of the physiopathology, the signs and symptoms, the evaluation, and the medical and surgical treatments of the most common neuromuscular conditions