This 2nd edition is designed as a text and a clinical reference, to provide students with the knowledge base for effective clinical decision making in dysphagia and to stimulate experienced clinicians with new ideas about patient assessment and management. This text is an attempt to review and synthesize the current state of knowledge in dysphagia in relation to both where the profession has been and where it is going and needs to go in the evaluation and treatment of oropharyngeal dysphagic patients. The first edition of this book was based on my experiences with 5,000 dysphagic patients. This second edition utilizes my experience with over 20,000 dysphagic patients. At least 50% of this text is new, when compared with the 1983 edition. There are additional chapters on swallow assessment procedures and on clinical decision making in treatment of dysphagic patients, as well as information on the influence of voluntary swallowing maneuvers on dysphagic patients, the effects of head injury and dementia on swallowing function, and a number of other topics. In addition to these new chapters and topics, there are entirely rewritten sections on normal swallow physiology, new imaging procedures for assessment of swallow, and new treatment procedures. 1 have kept all the relevant aspects of the 1983 text, such as the treatment procedures, and have added and expanded on those areas that are relatively new since 1983. The book is designed for the clinician interested in evaluation and treatment of swallowing disorders within the context of the total neuromotor control of the upper aerodigestive tract. I believe this book also provides clinicians with a set of evaluation and treat¬ment strategies that are workable in a variety of settings, including the schools. As dysphagia has grown in recognition, children and adults with dysphagia are being treated in a variety of settings; this is further encouraged by the changes put in place in the health care system.
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