## Overview Difficulty swallowing (dysphagia) occurs when the nerves or muscles that coordinate the swallow are damaged. Food or water may return through the nostrils, and there is risk of aspiration pneumonia. Common causes include guttural pouch disease, retropharyngeal abscess, or neurologic injury. ## Causes Damage to cranial nerves IX, X, or XII, or to the pharyngeal muscles themselves. ## Diagnosis Observation of eating and drinking, endoscopic examination of the pharynx and guttural pouches, and neurologic assessment. ## Treatment Address the underlying cause (for example, treatment of guttural pouch mycosis or abscess drainage). Supportive care includes feeding modifications and management of aspiration. ## Recovery and Prognosis Variable. Some nerve injuries improve; others are permanent. Aspiration pneumonia worsens the outlook. ## Prevention Prompt treatment of guttural pouch or upper-airway infections.
food or water returning from the nostrils; coughing while eating; weight loss; risk of aspiration pneumonia
## Overview Difficulty swallowing (dysphagia) occurs when the nerves or muscles that coordinate the swallow are damaged. Food or water may return through the nostrils, and there is risk of aspiration pneumonia. Common causes include guttural pouch disease, retropharyngeal abscess, or neurologic injury. ## Causes Damage to cranial nerves IX, X, or XII, or to the pharyngeal muscles themselves. ## Diagnosis Observation of eating and drinking, endoscopic examination of the pharynx and guttural pouches, and neurologic assessment. ## Treatment Address the underlying cause (for example, treatment of guttural pouch mycosis or abscess drainage). Supportive care includes feeding modifications and management of aspiration. ## Recovery and Prognosis Variable. Some nerve injuries improve; others are permanent. Aspiration pneumonia worsens the outlook. ## Prevention Prompt treatment of guttural pouch or upper-airway infections.
food or water returning from the nostrils; coughing while eating; weight loss; risk of aspiration pneumonia