**1. Introduction**

Surgical approaches to the cervical spine include anterior, posterior, trans-oral, lateral trans-mandibular which can be done by open, tubular MIS or full endoscopic as described recently.

Anterior cervical spine surgery is commonly performed for the treatment of varieties of cervical spine pathologies that include degenerative, trauma, tumors, deformities and infections [1].

Techniques of anterior cervical spine surgery include anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), for primary stability and fusion different type of devices are used, such as cages, plates, cylinders, as well as bone growth promoters, substitutes, and bone morphogenic protein (BMP) have been use. In selected cases, discectomy alone is also performed especially through MIS or endoscopic techniques [2].

Anterior cervical discectomy and fusion (ACDF) was first described by Smith Robinson in 1968, when he performed discectomy and fusion was done using tricortical bone graft, during 1990s more than 500,000 anterior cervical discectomy and fusion (ACDF) was done in USA [3].

Anterior cervical spine surgery is safe and effective harboring a wide range of indications with a low rate of morbidity and mortality [4]. Complications following anterior cervical spine surgery include airway complications, dysphagia, dysphonia, infection, implant failure, non-union, neurological deficit, vascular injuries, implant subsidence, adjacent level disease and even death [5–10].

Dysphagia is one of the most common complications following anterior cervical spine surgeries, dysphagia is a symptom indicative of an abnormality in the neural control of, or the structures involved in, any phase of the swallowing process, which involve both voluntary and involuntary/reflex responses. Oropharyngeal dysphagia is an impairment in the speed and/or safe delivery of food materials from entry in the mouth to the upper portion of the esophagus. If present, the patient is at an increased risk of

#### *Dysphagia - New Advances*

aspiration and may be unable to swallow properly liquids, foods, or saliva. The condition is considered long standing if it is still present more than 4 weeks after surgery [11].

Dysphagia following anterior cervical surgery can occur in the three phases of swallowing process (oral & transport phase, pharyngeal & esophageal) [12].
