The relationship between lesion localization and swallowing disorders

Abstract

Swallowing disorders (dysphagia) include difficulty in swallowing and controlling saliva, as well as feeding difficulties. These disorders affect all age groups from newborns to the elderly and can be the result of congenital abnormalities, damage of anatomical structures that affect swallowing, as well as various medical conditions. Dysphagia may be acute (eg. stroke) or may progress over time (eg. tumors and progressive neurological diseases). Numerous regions participate in the act of swallowing and they include precentral gyrus, postcentral gyrus, premotor zone, the supplementary motor area, operculum, insula, precuneus, prefrontal cortex, temporal lobe, cerebellum, brainstem, the frontal lobe, association areas, thalamus, and basal ganglia. It is extremely important to understand the swallowing process in order to further give an adequate approach in the treatment of disorders of this function.

Poremećaji gutanja (disfagija) obuhvataju kako teškoće u gutanju i kontrolisanju pljuvačke, tako i teškoće prilikom hranjenja. Ove smetnje pogađaju sve starosne grupe, od novorođenčeta do starijih i mogu biti posledica kongenitalnih abnormalnosti, oštećenja anatomskih struktura, koje utiču na gutanje, kao i različitih medicinskih stanja. Disfagija može da bude akutna (npr. izazvana moždanim udarom) ili može da progredira tokom vremena (npr. izazvana tumorima i progresivnim neurološkim bolestima). Brojne regije učestvuju u aktu gutanja i uključuju precentralni girus, postcentralni girus, premotornu zonu, suplementarnu motornu zonu, operculum, insulu, precuneus, prefrontalnu areu, temporalni režanj, Mali mozak, moždano stablo, frontalni režanj, capsulu interna, asocijativna polja, talamus i bazalne ganglije. Od izuzetne je važnosti razumevanje procesa gutanja, radi daljeg planiranja adekvatnog pristupa u tretmanu poremećaja ove funkcije.