Dysphagia: Diagnosis and Management, 2d ed.

Groher ME, ed. Boston, MA 02180, Butterworth-Heinemann, 1992, hardback, 349 pp, illus, $49.95.

A physical therapist or physical therapist assistant involved with a feeding rehabilitation team will find this reference valuable. in its second edition, the book lists 13 contributors (neurologists, otolaryngologists, gastroenterologists, radiologists, speech pathologists, a dietitian, and an occupational therapist), all part of a team approach in the treatment of swallowing disorders.

Approximately a third of the book is devoted to a thorough review of the anatomy and neuroregulation of swallowing and oral feeding. Disorders of myogenic, neurogenic, and carcinogenic origins are fully explained. One chapter is devoted to feeding impairments in infancy and childhood; however, most of the emphasis in this chapter is on the anatomy and neuroanatomy of the suckle-swallow mechanism. Techniques of remediation are briefly mentioned.

The second half of the book is devoted to clinical examination and treatment of swallowing disorders, depending on the etiology. Positioning, feeding devices, nutritional considerations, and adaptive equipment are surveyed. Enteral and parenteral feeding methods are discussed as well as tracheostoma tubes and other surgical interventions that aid in restoring swallowing.

Each of the 14 chapters is organized into numerous sections, with an extensive bibliography at the end of each chapter. There are illustrations, radiographic pictures, and detailed anatomical drawings to clarify the text. With the emphasis on team evaluation and management, the authors have provided an overview and reference text. For more detailed explanations of feeding interventions and adaptive equipment (particularly in infants and children), the physical therapist will have to seek out other references as this reference is geared more to understanding anatomy, clinical diagnosis and interventions, and nutritional considerations.