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Dysphagia is defined as an impairment of this complex and integrated sensorimotor system. It is estimated that 400,000 to 800,000 individuals worldwide develop neurogenic dysphagia per year. Neurogenic dysphagia is typically occurring in patients with neurological disease of different etiologies. A correct and early diagnosis and an appropriate management of dysphagia could be useful for improving patient's quality of life and may help to prevent or delay death. In the present review, we discuss thoroughly the anatomy and physiology of swallowing and also the pathophysiological mechanisms involved in impaired swallowing, as well as the diagnosis, management, and potential treatments of neurogenic dysphagia. Assessment of neurogenic dysphagia includes medical history, physical exam, and instrumental examinations (fiberoptic endoscopic evaluation of swallowing, videofluoroscopic swallowing study, electromyography). Pharmacological treatment of these problems includes oral anticholinergic drugs. Surgical myotomy of the cricopharyngeal muscle showed an important improvement of oropharyngeal dysphagia associated to upper esophageal sphincter hyperactivity. Chemical myotomy of the upper esophageal sphincter by local injections of botulinum toxin type A into the cricopharyngeal muscle has been proposed as an alternative less invasive and less unsafe than surgical myotomy. [ABSTRACT FROM AUTHOR]

After parotid surgery, gustatory sweating and flushing occur more frequently, the former reportedly in 15–100 % of cases, while no reliable data are available for the latter. Although botulinum toxin (BoNT) is effective in controlling sweating, little is known about its effect on flushing. In 17 patients suffering from Frey's syndrome after parotid surgery, we studied the gustatory flushing phenomenon as compared to gustatory sweating, analyzing their frequency, area, type of stimulus and response to BoNT administration. Cutaneous blood flow (CBF) was monitored by laser Doppler flowmetry (LDF) on affected and unaffected areas of the cheek in basal conditions and after meals, before and then 1 month after starting the BoNT injections. The Minor test was used to identify the sweating area. Flushing was observed in 7 of 17 patients after masticatory activity, spicy meals or citrus fruits. No clinical data correlated with any presence of flushing. Flushing regressed completely after BoNT administration and CBF reached similar values in the affected and unaffected sites. No adverse effects were observed. BoNT administration proved an effective and safe treatment for gustatory sweating and flushing in patients with Frey's syndrome. [ABSTRACT FROM AUTHOR]

The article studies the nasal microbiology of patients with sinonasal polyposis and chronic sinusitis treated with functional endoscopic sinus surgery (FESS). The isolation rate of Burkholderia cepacia complex (Bcc), a gram-negative bacteria, in sinonasal polyposis patients without cystic fibrosis is examined. The pre-operative and post-operative cultures of the species including Staphylococcus aureus, Bcc, Pseudomonas aeruginosa and others are also studied.

A letter to the editor is presented that provides information on the application of botulinum toxin treatment for oropharyngeal dysphalgia caused by tetanus.

Swallowing disorders are present in more than one-third of multiple sclerosis (MS) patients. Dysphagia in MS usually receives limited attention, maybe because of the unpredictability and variability of the disease among patients. Complications of dysphagia such as dehydration and aspiration pneumonia are a common cause of death and morbidity in late MS. For the effectiveness of swallowing rehabilitation in MS-related dysphagia we suggest that all MS patients should have a thorough evaluation of swallow ability. [ABSTRACT FROM AUTHOR]

Dysphagia can complicate multiple sclerosis (MS). Its real prevalence may be estimated to be around 30%–40%. Furthermore, dysphagia is life-threatening. In fact, its complications such as dehydration and aspiration pneumonia are a common cause of death and morbidity in late MS. The management of dysphagia should be focused on treatment of the specific dysphagic symptom and the underlying pathophysiology. The symptomatic management of dysphagia is based on two different types of approaches: the rehabilitative treatment and the pharmacological treatment. Botulinum toxin treatment may be a valid therapy in MS patients with oro-pharyngeal dysphagia associated with upper oesophageal sphincter hyperactivity. [ABSTRACT FROM AUTHOR]

Presents a corrected reprint of an article in the "European Archives of Oto-Rhinolaryngology" periodical.