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By Christopher L. B. Lavelle

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5) Other causes: multiple sclerosis; tuberculosis; syphilis; neoplasms; degenerative disorders. of the neurological and mechanical disorders of deglutition are different, some of the problems are shared: for example, excessive expectoration of fluid resembling saliva (sialorrhoea), masticatory difficulties, oral and pharyngeal pooling, lengthened swallowing transit times, difficulty in channelling food into the oesophagus, and aspiration. ) Most of the patients with mechanical dysphagia have had oral, pharyngeal or laryngeal structures removed or reconstructed during surgery for cancer, although there may be other causes: (1) Acute inflammations: acute pharyngitis; lingual tonsilitis; herpes simplex; chemical inflammation due to corrosive fluid swallowing.

During this anterior alveolar phase, the voluntary opening of the peripheral seal begins with the depression of the posterior tongue and elevation of the soft palate. Concurrently, the lips are closed and the maxillary and mandibular incisors come together. The anterior half of the tongue is then pressed against the maxillary alveolar ridge and the anterior half of the hard palate in rapid sequence, moving the bolus posteriorly on the dorsum and root of the tongue towards the pillars of the fauces-the midpalatal phase.

3 The superior constrictor is external to salpingopharyngeus, palatopharyngeus and palatolaryngeus, and the inferior constrictor is external to stylopharyngeus. The tongue, hyoid bone and larynx comprise an intrinsically mobile column controlled by muscles joining it to the basicranium, mandible and pterygoid regions of the face. In man, the upper 2 cm portion of the oesophagus is striated muscle 9 and continues the muscular pattern of the 32 Deglutition pharynx as it is held in position by its continuity with the pharynx.

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