Dysphagia with respiratory/pulmonary presentation: assessment and management

Breathing and swallowing are two of the most important basic functions that must be established at or soon after birth. Although each function serves a different purpose, they are intimately related by virtue of their sharing the same anatomic conduit for air and food. Thus, problems associated with swallowing and feeding can present with airway symptoms, and conversely, an airway problem may be made worse by feeding. This article discusses functional anatomy in relation to the clinical manifestations of airway problems in children with feeding problems. Evaluation and treatment of the most common problems by anatomic location is described, and the special complications of tracheotomy, chronic aspiration, and chronic sialorrhea (drooling) are considered in detail.