Oropharyngeal dysphagia profiles in individuals with oculopharyngeal muscular dystrophy

• Published in: Neurogastroenterology and motility 2018-04, Vol.30 (4), p.e13251-n/a
• Main Authors: Tabor, L. C., Plowman, E. K., Romero‐Clark, C., Youssof, S.
• Format: Article
• Language: English
• Subjects: Clinical trials; deglutition; Dysphagia; Efficiency; Muscular dystrophy; Pharynx; Respiratory tract; Safety; Swallowing; swallowing disorders; Toxicity
• ISSN: 1350-1925; 1365-2982
• DOI: 10.1111/nmo.13251

Background Although dysphagia represents a hallmark manifestation of oculopharyngeal muscular dystrophy (OPMD), limited knowledge exists regarding the underlying nature of oropharyngeal swallowing impairments in this patient population. We aimed to delineate global pharyngeal dysphagia profiles in OPMD and identify the prevalence and physiologic associations of impairments in swallowing safety and efficiency. Methods Twenty‐two individuals with OPMD completed a videofluoroscopic swallowing evaluation. Blinded raters completed validated scales of global dysphagia (dynamic imaging grade of swallowing toxicity, DIGEST), efficiency (normalized residue ratio scale, NRRS), and safety (penetration‐aspiration scale, PAS). Degree of laryngeal vestibule closure and aspiration events were described. Descriptives and chi‐squared analyses were conducted with alpha set at P 1). Presence of a cricopharyngeal bar was noted in 10 individuals. The predominant swallowing categorization across patients was safe and inefficient (51%) followed by unsafe and inefficient (32%). 77.3% demonstrated vallecular residue (NRRSv>0.07) and 90.1% piriform sinus residue (NRRSp > .20). 33% (n = 54) of swallows were unsafe (PAS>3) with 45 episodes of penetration and 9 episodes of aspiration. Aspiration occurred during the swallow in 100% of identified occurrences. Incomplete epiglottic inversion was associated with airway compromise and postswallow residue (P