Report - 12th January 2010

Oral Feeding Difficulties in Neurological Disease

On 12th January Dr Tom Hughes stepped in at short notice to present in place of Dr Tunstall-Pedoe who was unable to attend due to health issues. Unfortunately on 12th there was another heavy snowfall and numbers were limited to a few hardy souls.

Dr Hughes presented an entertaining and illuminating talk on Oral Feeding Failure (OFF) in neurological disease, a subject which is common in both primary and secondary care. He outlined with great clarity the anatomy, neurology and mechanisms of swallowing. He emphasised the importance of the larynx as centre stage in speech and swallowing. The determinants of successful swallowing being laryngeal elevation, , bolus preparation, opening of cricopharynx, bolus propulsion and laryngeal closure. Feeding requires the integration of breathing and swallowing requiring the ability to cough, respiratory function (FVC) and head control. The determinants of successful oral feeding involve many factors as outlined in this very illuminating slide and the importance of two essential but frequently forgotten aspects were highlighted as consistency of food and carers. He summarised by suggesting that oral feeding is a composite function comprising a number of other composite functions and the term Oral Feeding Failure (OFF) facilitates a broader discussion than does the term dysphagia.