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Dysphagia in Parkinson's Disease Improves with Vocal Augmentation
R J Howell1, H Webster2, E Kissela3
1Department of Otolaryngology, Head and Neck Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML #0528, Cincinnati, OH, 45267-0528, USA. howellrb@ucmail.uc.edu.
Dysphagia
|January 30, 2019
Summary
Vocal fold augmentation through injection laryngoplasty (IL) shows promise in improving swallowing difficulties for Parkinson's disease (PD) patients with vocal bowing. This study suggests IL may be a beneficial addition to managing dysphagia in PD.
Area of Science:
- Neurology
- Otolaryngology
- Speech-Language Pathology
Background:
- Parkinson's disease (PD) commonly causes voice disorders, but dysphagia (swallowing difficulty) is less frequently studied.
- Vocal fold augmentation, specifically injection laryngoplasty (IL), is an established treatment for glottal insufficiency.
Purpose of the Study:
- To evaluate the impact of IL on glottic closure and patient-reported dysphagia in PD patients with vocal bowing.
- To assess the effectiveness of IL with or without speech therapy.
Main Methods:
- Retrospective cohort case series of 14 PD patients undergoing IL.
- Pre- and post-operative assessments included stroboscopic examinations and validated patient-reported outcome tools (RSI, GFI, EAT-10).
- Patient data included demographics, PD severity (MDS-UPDRS), and time since diagnosis.
Main Results:
- All 14 patients showed improvement in patient-reported swallowing measures (ΔRSI=4, ΔGFI=3, ΔEAT-10=4).
- The study included patients with moderate PD severity (MDS-UPDRS 33±20) and a mean age of 70 years.
- While stroboscopic exams were common, formal swallowing evaluations were limited to 4 patients.
Conclusions:
- Dysphagia is a significant issue in progressive neurodegenerative conditions like PD.
- Pilot data suggest injection laryngoplasty may serve as a beneficial adjunct therapy for PD patients experiencing glottal insufficiency and associated dysphagia.
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