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Related Experiment Videos

Inflammatory myopathy causing pharyngeal dysphagia: a new entity

J Shapiro1, S Martin, U DeGirolami

  • 1Department of Otology and Laryngology, Harvard Medical School, Beth Israel Hospital, Boston, Massachusetts, USA.

The Annals of Otology, Rhinology, and Laryngology
|May 1, 1996
PubMed
Summary

This study identifies a new cause of swallowing difficulty in older adults, characterized by muscle changes in the throat and specific videofluoroscopy findings. It highlights a distinct clinical entity of pharyngeal dysphagia.

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Area of Science:

  • Otolaryngology
  • Neurology
  • Gastroenterology

Background:

  • Dysphagia, or difficulty swallowing, is a common complaint, particularly in the elderly.
  • Neurological and structural causes are often investigated, but some cases remain unexplained.

Purpose of the Study:

  • To describe a distinct clinical entity of isolated pharyngeal dysphagia in elderly patients.
  • To characterize the unique videofluoroscopic and pathological findings associated with this condition.

Main Methods:

  • Case series of seven elderly patients presenting with solid food dysphagia.
  • Comprehensive evaluation including neurologic assessment, electromyography, nerve conduction studies, fiberoptic laryngoscopy, and videofluoroscopy.
  • Muscle biopsies of the omohyoid and cricopharyngeus muscles were performed in some patients.

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Main Results:

  • Patients exhibited normal neurological evaluations and tests.
  • Fiberoptic laryngoscopy revealed saliva pooling in pharyngeal recesses.
  • Videofluoroscopy showed prominent cricopharyngeus muscle, decreased epiglottic tilt, and pharyngeal residue.
  • Muscle biopsies indicated inflammatory myopathy without inclusion bodies.

Conclusions:

  • A distinct clinical entity of isolated pharyngeal dysphagia in the elderly is identified.
  • This condition is characterized by specific videofluoroscopic findings and an underlying pharyngeal myopathy.
  • Pharyngoesophageal sphincter myotomy was performed in three patients, suggesting a potential therapeutic approach.