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Rehabilitacion 2003;37:40-54 - DOI: 10.1016/S0048-7120(03)73331-3
Tratamiento de la disfagia orofaríngea
Treatment of oropharyngeal dysphagia
H. Bascuñana Ambrós, , S. Gálvez Koslowski
Clínica MATT. Tarragona.
Recibido 27 agosto 2001, Aceptado 05 marzo 2002
Resumen

El objetivo principal de cualquier estrategia de tratamiento para un paciente disfágico es conseguir una alimentación oral con una deglución segura mientras se mantienen una hidratación y nutrición adecuadas. Existen dos grupos de estrategias de tratamiento: las técnicas compensatorias y las técnicas de tratamiento propiamente dichas. Las primeras tratan de redirigir el bolo y así eliminar los síntomas de disfagia aunque no modifican necesariamente la fisiología de la deglución. Están controladas por el terapeuta o cuidador y se pueden realizar en todas las edades y niveles cognitivos. Las técnicas de tratamiento están diseñadas para cambiar la fisiología de la deglución, tratan de mejorar la movilidad de las estructuras orales y faríngeas, aumentar la velocidad de disparo del reflejo faríngeo o controlar de forma voluntaria la movilidad orofaríngea durante la deglución. Suelen precisar de la colaboración del paciente ya que éste debería practicarlas de forma independiente para obtener los mejores resultados.

El decidir cuál o cuáles se deben utilizar dependerá de varios factores siendo fundamental la exploración clínica y radiográfica.

Summary

The principal objective of any treatment strategy for a dysphagic patient is to obtain oral feeding with a safe swallowing while maintaining adequate hydration and nutrition. There are two treatment strategy groups: the compensatory techniques and treatment techniques themselves. The former try to redirect the bolus and thus eliminate the dysphagia symptoms although they do not necessarily change the swallowing physiology. They are controlled by the therapists or caretaker and can be performed at all ages and cognitive levels. The treatment techniques are designed to change the swallowing physiology, try to improve the mobility of the oral and pharyngeal structures, increase the trigger rate of the pharyngeal reflex or voluntarily control the oropharyngeal mobility during swallowing. They generally require the collaboration of the patient since this should be performed independently to obtain the best results.

Deciding which should be used will depend on several factors, the clinical and radiographic examination being fundamental.

Palabras clave
Disfagia, Deglución, Técnicas, Tratamiento, Maniobras deglutorias
Key words
Dysphagia, Swallowing, Techniques, Treatment, Swallowing maneuvers
El Texto completo solo está disponible en PDF
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Correspondencia: Helena Bascuñana Clínica MATT. Servicio de RHB Pin i Soler, 12 43002-Tarragona (H. Bascuñana Ambrós hbascunana@matt.es)
Copyright © 2003. Sociedad Española de Rehabilitación y Medicina Física (SERMEF) y Elsevier España, S.L.