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Dysphagia in patients with Duchenne muscular dystrophy evaluated with a questionnaire and videofluorography
Authors:Hanayama Kozo  Liu Meigen  Higuchi Yoshiko  Fujiwara Toshiyuki  Tsuji Testuya  Hase Kimitaka  Ishihara Tadayuki
Affiliation: a Department of Rehabilitation Medicine, Tokai University School of Medicine, Kanagawa, Japanb Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japanc Department of Neurology, National Hakone Hospital, Kanagawa, Japan
Abstract:Purpose. To investigate swallowing problems in patients with Duchenne muscular dystrophy (DMD) using a questionnaire and videofluorography (VF).

Method. A questionnaire survey was performed of swallowing-related symptoms and VF in 31 male patients with DMD (mean age 19.9 years, range 9 - 26 years). The relationships among age, frequency of symptoms and VF abnormalities were analysed using Spearman's rank correlation. The differences in VF abnormalities among different food textures were analysed with the Kruskal - Wallis test.

Results. Symptoms related to pharyngeal phase dysfunction were more frequent than those related to oral and oesophageal phases. Coughing while eating was seen in 71% of the patients, choking while eating in 32% and the need to clear the throat in 26%. VF abnormalities were observed in 30 patients (96.8%). Common VF abnormalities included pooling in the valleculae (90.3%) and in the pyriform sinus (90.3%). Pharyngo-oral regurgitation was seen in 35.5% of the patients. Pooling in the pyriform sinus after repeated swallowing seen in VF correlated significantly with symptoms related to the pharyngeal phase (Spearman's rho 0.356 - 0.544).

Conclusion. Because oropharyngeal dysphagia in DMD was evident in teenage patients as well as those without clinical symptoms, VF is recommended in patients with DMD.
Keywords:Muscular dystrophy  dysphagia  videofluoroscopy
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