Swallowing Disorders
Definition
Swallowing disorders, also known as dysphagia, are conditions that involve difficulty or discomfort in the process of moving food or liquid from the mouth to the stomach. These disorders can result from various causes, including neurological issues, structural abnormalities, or muscle dysfunction in the mouth, throat, or esophagus.
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Head & Neck Cancers Program
The Head and Neck Cancers Program at Smilow Cancer Hospital provides total care, as well as innovative and organ-sparing treatment options to patients with cancers of the head and neck. Our team sets the tone nationally and internationally for clinical trials and state-of-the-art cancer care. By carefully balancing treatment efficacy with quality-of-life, our collaborative approach to care personalizes treatment for tumors affecting the neck, larynx (voice box), pharynx (throat), oral cavity (mouth), ear, sinuses, tonsils, and salivary glands, as well as cervical (neck) lymph nodes or neck structures. Our multidisciplinary team includes head and neck surgeons, radiation oncologists, medical oncologists, pathologists, physical therapists, speech-language pathologists, nutritionists, a smoking cessation specialist, dentists, a physical/lymphedema therapist, advanced practice nurses, and social workers. Functional outcome is an important element in deciding which treatment approach is recommended. Our program offers a promising new surgical technique, transoral robotic surgery (TORS), that can be used to remove certain throat cancers while avoiding skin and bone incisions. This approach speeds healing and shortens a patient’s hospital stay. Likewise, patients with certain laryngeal cancers, who a few years ago would have lost their vocal cords and their voices, can often be treated with less invasive surgeries. Patients who undergo these treatments maintain their ability to speak, although they may need to alter their diet or learn new swallowing techniques. At Yale, rehabilitative specialists work with patients to help them adjust to and overcome some of these swallowing impairments. In many cases, radical neck dissections have been replaced by less radical surgeries that preserve the nerves, arteries, and muscles in the neck. Patients continue to move, speak, breathe, and eat normally after less radical surgeries, without sacrificing cure rates. Additionally, in recent years, the field of reconstructive surgery has achieved many breakthroughs, yielding previously unattainable cosmetic and functional outcomes. Medical Oncology Our medical oncologists have unique expertise in head and neck cancers and dedicate their practice entirely to cancers of the head and neck. The integration of chemotherapy with radiation has become very important for patients with head and neck cancers that involve the lymph nodes or is locally extensive, and this approach can lead to organ preservation and increase the chance of cure for many patients. Breakthroughs in targeted therapy and biomarkers allow a personalized approach that can avoid the toxicities of conventional chemotherapy in some cases, and new treatments to prevent recurrence in high-risk situations are also being studied. For patients with recurrent disease, new anti-cancer drugs and immunotherapies are also available. A study led by Yale Cancer Center revealed that the checkpoint inhibitor pembroliPediatric Gastroenterology & Hepatology
We provide expert, compassionate inpatient and outpatient care for children with a variety of gastrointestinal, liver, and metabolic disorders including inflammatory bowel disease, esophageal disorders, diarrheal disease, acute and chronic liver disease, and metabolic liver diseases, including lysosomal diseases. Our care team harnesses the expertise of gastrointestinal nursing, nutrition, radiology, surgery and genetics experts, as well as Yale’s programs in inflammatory bowel disease and liver transplantation. Our multidisciplinary approach for our patients with nonalcoholic fatty liver disease also includes a clinical psychologist, a dietician, and an endocrinologist.The program also offers selective shunts for patients with noncirrhotic portal hypertension. Gastrointestinal conditions we often manage include: Abdominal Pain Celiac disease Constipation/Encopresis Eosinophilic esophagitis/allergic bowel disease Failure to thrive Feeding problems/swallowing problems Helicobacter pylori infection Hirschsprung’s disease Lactose intolerance Malabsorption Pancreatitis Peptic ulcer disease Vomiting Our pediatric hepatologists treat a range of liver diseases. Some can be managed with medication, while others require surgery. For example,acute liver failure(ALF) occurs when many of the cells in the liver die or become very damaged in a short period of time. ALF has many causes, such as metabolic conditions or toxicity from incorrect dosages of acetaminophen.ALF can sometimes be treated with medication, if it is identified early, but about half of all children who develop ALF require a liver transplant. Biliary atresiais a disease of the liver and bile ducts that occurs in infants. In children with biliary atresia, bile—a liquid that helps the body digest fat—cannot properly drain from the liver. This damages liver cells and can lead to liver failure. Surgical procedures can correct bile flow problems, but the liver disease progresses and requires specialized care to improve growth, development, nutrition, and long-term outcome.A multidisciplinary team consisting of pediatric liver specialists, surgeons, and a dietician provides comprehensive care for patients with biliary atresia. Other hepatology conditions we treat include: Alagille syndrome Alpha-1-antitrypsin deficiency Autoimmune hepatitis Neonatal cholestasis Progressive Familial Intrahepatic Cholestasis (PFIC) Urea cycle defects Wilson's disease Primary Sclerosing Cholangitis Glycogen Storage Disease Viral hepatitis Hepatoblastoma Nonalcoholic fatty liver diseaseRadiology & Biomedical Imaging
We are committed to providing patient-focused, evidence-based care to all of our patients, pairing clinical expertise with the latest advances in technology. We offer a comprehensive range of imaging services, and tailor each exam to meet each patient’s specific needs. Our board-certified doctors are national and international leaders in diagnostic imaging and advanced image-guided therapies, and they are dedicated to maintaining the highest standards of care in patient safety, quality, and satisfaction. We employ a multidisciplinary approach to care, and collaborate with physicians from all medical specialties to make the most accurate diagnosis and determine the best treatment options. Yale patients have access to highly advanced imaging equipment, including an intraoperative MRI/IR/OR suite, and 3D tomosynthesis. Our radiologists conduct advanced research in MRI, MRS, PET, interventional oncology, and image processing. Specialized care is offered in the following areas: Abdominal imaging Breast imaging Cardiovascular imaging Emergency and trauma radiology Neuroradiology Nuclear medicine and molecular imaging (including PET/CT) Pediatric radiology Thoracic imaging Vascular/interventional radiology Rapid, in-house subspecialist imaging interpretations Overnight coverage by three in-house attending radiologists at Yale New Haven Hospital Leader in 3D tomosynthesis mammography imaging and research Leader in screening breast ultrasound Comprehensive multidisciplinary lung cancer screening program with ultra-low-dose CT scanning Cardiac CoreValue planning service, providing a minimally invasive transcatheter aortic valve implantation option for patients with severe aortic stenosis MRI for pacemaker patients Ultrasound contrast and elastography imaging Dedicated peripheral vascular ultrasound Integrated musculoskeletal ultrasound device Subspecialized pediatric interventional radiology expertise Recognized expertise in management of primary and secondary liver cancer Molecular imaging for recurrent prostate cancer and the diagnosis of Alzheimer’s disease Advanced tumor imaging for optimizing best treatment outcomes DaTscan, a diagnostic test for Parkinson’s Disease Portable neuro Intensive Care Unit (ICU) computed tomography (CT) scanning Interventional radiology with state-of-the-art minimally invasive image-guided therapy, including targeted and precision cancer treatments, back pain treatment, and biliary stone laser treatment, among others