ABSTRACT
The voluntary oral phase of deglutition is controlled by the cerebral cortex and the brain stem. The involuntary pharyngeal phase is regulated by the brain stem. Dysfunction of the central nervous system or interruption of either sensory or motor transport pathways at the peripheral level can result in oropharyngeal dysphagia. The clinical presentation may vary and is influenced by the location of the damage and its extent. Hesitation and inability to initiate swallowing or inability to move food or liquid from the mouth to the pharyngeal cavity reflects dysfunction of the tongue, soft palate, or suprahyoid muscles. Poor transport from the pharynx to esophagus suggests dysfunction at the pharyngoesophageal junction. When oropharyngeal dysphagia occurs in response to voluntary deglutitions, misdirection of the food bolus usually causes symptoms by its misorientation: pharyngo-oral regurgitation, pharyngonasal regurgitation, laryngeal penetration, or tracheobronchial aspiration.
