Dysphagia is the medical term for difficulty swallowing. It refers to any problem with moving food, liquid, or saliva from the mouth through the throat and into the oesophagus. Dysphagia can range from a mild sensation of food sticking in the throat to a complete inability to swallow. It may indicate a structural, neurological, or inflammatory problem and should always be investigated by an ENT specialist.
ENT specialists assess and manage oropharyngeal dysphagia, which involves the throat and upper swallowing mechanism. Common causes include:
Structural causes: A pharyngeal pouch (Zenker's diverticulum), cricopharyngeal bar, throat or oesophageal stricture, web, or tumour can physically obstruct the passage of food. Enlarged tonsils or a thyroid mass may also cause compression.
Neurological causes: Stroke, Parkinson's disease, motor neurone disease, multiple sclerosis, and myasthenia gravis can impair the coordinated muscle movements required for swallowing.
Inflammatory causes: Severe reflux (laryngopharyngeal reflux or GORD), radiation therapy to the head and neck, and eosinophilic oesophagitis can all cause inflammation that leads to swallowing difficulty.
Age-related changes: Muscle weakness and reduced coordination of swallowing are common in the elderly and can increase the risk of aspiration.
At Central Sydney ENT, our surgeons conduct a comprehensive assessment of dysphagia that may include:
Flexible nasendoscopy provides direct visualisation of the throat, larynx, and upper oesophageal inlet to identify structural abnormalities, pooling of secretions, or masses.
FEES (Fibreoptic Endoscopic Evaluation of Swallowing) is performed collaboratively with a speech pathologist. The patient swallows food and liquid of different consistencies while the ENT specialist views the swallowing process through the nasendoscope. This identifies exactly where the swallowing breakdown occurs.
Additional investigations may include a barium swallow (videofluoroscopy), CT or MRI imaging, and panendoscopy under general anaesthetic to examine the throat and oesophagus and obtain biopsies if needed.
A speech pathologist provides targeted swallowing therapy including exercises to strengthen the swallowing muscles, techniques to improve swallowing safety, and dietary texture modifications to reduce aspiration risk. Our on-site speech pathologist works closely with our surgeons for coordinated care.
Oesophageal or pharyngeal strictures can be dilated endoscopically. Cricopharyngeal myotomy (dividing the tight upper oesophageal sphincter) can be performed endoscopically or through an external approach for cricopharyngeal dysfunction.
Pharyngeal pouches (Zenker's diverticulum) can be treated surgically with excellent outcomes. If a tumour is identified, treatment is planned through a multidisciplinary head and neck cancer team. Reflux-related dysphagia responds to medical therapy and lifestyle changes.
Seek specialist assessment if you have persistent difficulty swallowing lasting more than two weeks, if food regularly gets stuck, if you are losing weight unintentionally, or if you experience frequent coughing or choking during meals. Dysphagia in the context of a new neck lump, hoarseness, or ear pain should be assessed urgently.
Central Sydney ENT has six FRACS-qualified ENT surgeons and an on-site speech pathologist across seven Sydney locations in Burwood, Campbelltown, Gregory Hills, Ultimo, Drummoyne, Hunters Hill, and Miranda.
Ask your GP for a referral to Central Sydney ENT, or call our reception team directly.