Journal
MUSCLE & NERVE
Volume 63, Issue 6, Pages 874-880Publisher
WILEY
DOI: 10.1002/mus.27225
Keywords
aspiration; dysphagia; myositis; outcome measure; pneumonia
Categories
Funding
- Else Kroner-Fresenius-Stiftung [2017_EKMS.03]
Ask authors/readers for more resources
This study found that oropharyngeal dysphagia in patients with idiopathic inflammatory myopathy (IIM) is severe and associated with complications such as pneumonia. The main swallowing impairment is pharyngeal residue, and the quality of the endoscopic white-out can serve as a semi-quantitative surrogate marker for pharyngeal contractility.
Introduction Oropharyngeal dysphagia is a clinical hallmark of idiopathic inflammatory myopathy (IIM). This study investigated predictors, outcome, and characteristics of oropharyngeal dysphagia in patients with different types of IIM. Methods Flexible endoscopic evaluation of swallowing (FEES) videos of 71 IIM patients were retrospectively analyzed for bolus spillage, penetration, aspiration, and pharyngeal residue. Based on these findings, dysphagia severity was rated. Regression analyses were performed to investigate demographic and disease-specific predictors of dysphagia severity and pneumonia as outcome-relevant complications of dysphagia. A score was developed to rate the quality of the endoscopic white-out as a surrogate marker for pharyngeal muscle weakness with consecutive residue. Results Our analysis revealed no independent predictors of dysphagia severity. Dysphagia severity, however, was an independent predictor for pneumonia, which occurred in 24% of patients. Pharyngeal residue with risk of postdeglutitive aspiration was the most common dysphagia pattern. Attenuation of the endoscopic white-out was related to residue severity. Discussion Dysphagia in IIM assessed with FEES is associated with relevant complications, such as aspiration pneumonia, and must be considered independently of peripheral muscle weakness and disease duration. Swallowing impairment mainly presents with pharyngeal residue. The quality of the white-out may serve as a semi-quantitative surrogate marker for pharyngeal contractility.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available