Swallowing disorders : proposal of a method for forensic medicine assessment

For a correct classification of dysphagia, morphologic instrumental investigations capable of analysing the anatomical structures of the digestive tract, are undoubtedly essential, but the most important investigations are the functional investigations, such as videofluoroscopy, fiberoptic endoscopi...

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Bibliographic Details
Published in:Acta otorhino-laryngologica italica 2007-06, Vol.27 (3), p.129-133
Main Authors: FATTORI, B, URSINO, F, MATTEUCCI, F, MALLARDI, V, NACCI, A
Format: Article
Language:English
Subjects:
Biological and medical sciences
Deglutition Disorders - diagnosis
Deglutition Disorders - physiopathology
Endoscopy
Esophagus
Fiber Optic Technology
Forensic Medicine - methods
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Medical sciences
Other diseases. Semiology
Otorhinolaryngology. Stomatology
Pharynx - physiopathology
Speech therapy
Videotape Recording
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Summary:For a correct classification of dysphagia, morphologic instrumental investigations capable of analysing the anatomical structures of the digestive tract, are undoubtedly essential, but the most important investigations are the functional investigations, such as videofluoroscopy, fiberoptic endoscopic evaluation of swallowing, oro-pharyngo-oesophageal scintigraphy, manometry and pH-metry. Results of these examinations enable us to identify, in patients with dysphagia, the extent of permanent damage, as a consequence of injury to the structures designated to swallowing, must be such that it at least minimally impairs and decreases the relative function, but to a degree that can be detected and, in some manner, measured. From a legal point of view, alterations in swallowing, caused by damage to structures belonging to the respiratory-digestive tract, can be found in crimes against persons and particularly in those involving body injury. In the case of civil, but also in private or social insurance proceedings, it is necessary to distinguish which parameters are to be used as reference for evaluating and quantifying the injury in terms of reimbursement. With the introduction of complete biological well-being, injury is considered as an impairment of the worth and right to enjoy psychological-physical integrity as a quality of life. The criteria currently used internationally take into account the conception of psychological-physical efficiency; nevertheless, in Italian forensic medicine, there is no table that offers a thorough quantification of swallowing modifications, if one excludes oesophageal disorders. Herewith, an evaluation table, dividing oro-pharyngo-oesophageal dysphagia into five, progressively serious classes, is proposed.
ISSN:0392-100X
1827-675X