Protocol Based on our experience with three patients with severe COPD and clinically overt swallowing difficulties in whom cricopharyngeal dysfunction was verified, we studied an additional 22 patients with severe COPD who were subject to frequent exacerbations. All studies were performed in a community hospital. These studies were neither consecutive nor randomized, but were based [...]

The intimate developmental and anatomic relation­ships of the tracheobronchial tree and gastrointes­tinal tract have demanded a complex system for separating their functions. The process of swallowing is one aspect. Failure of all or part of this process may lead to aspiration of oropharyngeal contents, a recog­nized pathophysiologic entity which produces, for example, anaerobic pulmonary infections, [...]