Dysphagia due to Chemical Injury or Cervical Spine Injury

Lee, Yoon Se

Abstract

Caustic injury and spinal cord injury may induce pharyngeal and esophageal dysfunction, which frequently elicit dysphagia. Among the causes of dysphagia, these types of injury are related to anatomical and functional deterioration of the peripheral muscles and nerves. Various types of chemical materials cause upper aerodigestive tract burns, which induces stricture and dysphagia by scar formation. Endoscopic evaluation within 48 hours helps to predict the occurrence of stricture and dysphagia. The extent of injury or other additional complications should be assessed by plain X-ray and comupterized tomography (CT). The prevention of stricture, perforation, and dysphagia is a mainstay of treatment to reduce morbidity, and serial dilation with esophagogram and flap reconstruction should be considered in failure cases. Cervical spine injury itself causes mucosal tears or neuromuscular dysfunction, which can occur even during corrective surgery. Perforation should be evaluated by laryngoscopy, swallowing studies, plain X-ray, and CT. Both mechanical and functional obstruction that occur during the healing process can be managed by rehabilitative or surgical approaches. Dysphagia caused by chemical burns or cervical spine injury can provoke secondary complications such as aspiration pneumonia and malnutrition. Thus, adequate evaluation and management of anatomical and functional changes are required to prevent dysphagia and further complications, as well as to increase the quality of life of patients.