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- W90051981 abstract "Editor—There are serious omissions in the section on high dysphagia in Owen's article on dysphagia.1 It seems ill considered to discuss the causes of upper oesophageal dysphagia without proper consideration of the possibility of head and neck malignancy. We acknowledge that the possibility of oesophageal malignancy is mentioned in the accompanying box, but no mention is made of head and neck cancer in the main text.The incidence of head and neck cancer is increasing.2 Most patients with such cancer present with a combination of symptoms, of which cervical, or high, dysphagia is cardinal. It is imperative that patients presenting with high dysphagia are seen by a doctor experienced in assessing the upper aerodigestive tract, such as an ear, nose, and throat surgeon.The suggestion that radiology is more rewarding than endoscopy in the investigation of high dysphagia is misleading. Radiology—in particular, contrast studies—is of little value in the investigation of head and neck malignancy.3 As specialists, we visualise the pharynx and upper oesophagus with mirrors and a flexible laryngoscope and use rigid endoscopy under anaesthesia, which is the gold standard for investigation of this difficult area.In summary, patients presenting with high dysphagia with no obvious neurological cause should be referred promptly to an ear, nose, and throat surgeon." @default.
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- W90051981 date "2002-03-09" @default.
- W90051981 modified "2023-09-25" @default.
- W90051981 title "Dysphagia" @default.
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- W90051981 doi "https://doi.org/10.1136/bmj.324.7337.613" @default.
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