The first edition of Comprehensive Management of Swallowing Disorders was published in 1999 by Singular Publishing Group. When Singular was sold, the new company retained the contract. The text continued to sell despite the lack of active marketing. Eventually, the authors (R.L.C., T.M.) successfully reacquired the rights to the book. A second printing by Plural Publishing Incorporated in 2006 resulted in continued strong interest in the book.
The continued interest in the first edition was the stimulus to produce this new and updated edition. Drs. Carrau and Murry were fortunate to be joined by Rebecca Howell, MD as a coeditor. Dr. Howell brings a new enthusiasm to the book and a new group of dysphagia specialists to the second edition. With several authors from the first edition and the addition of new authors, the editors have updated each section of the book. This edition represents the broad interests of the medical, surgical, and behavioral specialists who treat swallowing disorders. The authors bring their research and teaching expertise to the contents of the revised book. The second edition of Comprehensive Management of Swallowing Disorders is both a clinical reference as well as a textbook for all specialists involved in dysphagia teaching and clinical care.
The continued interest in the first edition was the stimulus to produce this new and updated edition. Drs. Carrau and Murry were fortunate to be joined by Rebecca Howell, MD as a coeditor. Dr. Howell brings a new enthusiasm to the book and a new group of dysphagia specialists to the second edition. With several authors from the first edition and the addition of new authors, the editors have updated each section of the book. This edition represents the broad interests of the medical, surgical, and behavioral specialists who treat swallowing disorders. The authors bring their research and teaching expertise to the contents of the revised book. The second edition of Comprehensive Management of Swallowing Disorders is both a clinical reference as well as a textbook for all specialists involved in dysphagia teaching and clinical care.
Clinicians who pioneered work in dysphagia are the impetus for the second edition of this text. From the time when swallowing was taken for granted to the present day, research in every aspect of eating, chewing, swallowing, nutrition, and quality of life has advanced the rehabilitation of patients with swallowing problems. The treatment of swallowing disorders continues to grow as a medical specialty and a science and is no longer overlooked in the overall management of patients suffering from disorders such as a stroke, cancer, and other acute or chronic catastrophic diseases. We have seen the changes in clinical pathways that have occurred in major medical centers to improve the rehabilitation of patients through the efforts of those who treat swallowing.
It is because of the ever-evolving changes in the management of swallowing disorders and the inevitable and necessary interaction with all the many specialists who treat swallowing disorders that we elected to revise the original text and represent all the specialties that manage dysphagia. Our experience, gained after a number of years working in a multidisciplinary environment, studying swallowing both in the normal and disordered populations, is that swallowing problems are complex even when the diagnosis is known. Moreover, our philosophical approach is that swallowing is not the domain of only speech pathologists or the medical or surgical specialists. Rather, it is in the best interest of the patients suffering from a swallowing disorder that all clinicians involved in their care be active participants in their rehabilitation.
This second edition of Comprehensive Management of Swallowing Disorders addresses the swallowing problems from the point of view of all those specialists in medical, surgical, and rehabilitative medicine who are involved in the management of these patients. We feel that each discipline must understand each other’s role in the management of swallowing disorders. Central to that notion is the understanding of the normal swallow. We have devoted a considerable number of pages to the normal pediatric and adult swallow, including a detailed discussion of the anatomy, physiology, and pathophysiology of swallowing. The clinician who understands the anatomy, physiology, and neurology of normal swallowing will better understand the effects of diseases, disorders, and functional changes that present as swallowing disorders. We have revised all of the chapters and invited 77 authors who are currently in the forefront of dysphagia management, research, and teaching.
This text is divided into seven sections. In the first section, an introduction to the myriad of swallowing disorders is presented. A vast array of conditions that are associated with swallowing disorders and their epidemiology are introduced.
Part II describes the anatomy and physiology of swallowing. Both the organs of swallowing and the normal swallow are reviewed in detail. “The Normal Swallow,” written by Dr. Howell, updates the latest understanding of normal swallowing physiology.
Part III addresses the evaluation of swallowing from seven perspectives: otolaryngology, speech pathology, pediatrics, gastroenterology, neurology, physical and rehabilitative medicine, nutrition, and surgery. Each specialist describes the clinical evaluation and procedures that he or she uses when first evaluating a patient with a swallowing problem. Although some of these techniques are similar among all and, therefore, the text may appear to be repetitive, each discipline provides a unique perspective on the aspects important for making a diagnosis and planning treatment.
Part III also includes chapters on various tests of swallowing function. These include the various radiographic examinations, endoscopic tests of swallowing, gastroenterology tests, and electromyography. The benefits and disadvantages, along with the complications, of each test are described.
Part IV contains 18 chapters that cover all aspects of the pathophysiology of swallowing disorders. This section of the text is a “tour de force” of medical, surgical, and neurological problems that lead to swallowing disorders; the identifying signs and the disorders; and, in some chapters, case studies of management. The detail with which this section of the book is assembled reflects the strong multidisciplinary nature of the entire text.
Part V is devoted to the nonsurgical treatment of swallowing disorders. Four chapters are devoted to diet modification, behavioral techniques, prosthodontics, and swallowing management of adults with tracheotomies. Each chapter includes methods and procedures for each stage of swallow rehabilitation. Nonsurgical rehabilitation of swallowing has advanced from the early trials to a functional framework of treatment based on the swallowing disorder.
Part VI reviews the surgical treatments of swallowing disorders. These chapters are devoted to the various surgical procedures that are both temporary and permanent treatments for laryngeal, pharyngeal, esophageal, and gastric disorders.
Part VII addresses swallowing problems in special populations. Special problems of the pediatric population are addressed, as well as problems of critical care patients, aging patients, terminally ill patients, and patients with intractable aspiration pneumonia. A final chapter discusses future trends in the management of dysphagia.
We are indebted to the many specialists who have taken time to address swallowing from a multidisciplinary perspective. Their commitment to this text reflects the commitment that they profess to the diagnosis and treatment of swallowing disorders. Each contributor has kept the focus of this text in mind when addressing his or her specific topic.