High Resolution Manometry versus Video Fluorography for Evaluating Dysphagia in Patients with Inflammatory Myopathy: A Pilot Study
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Objective: Dysphagia has been reported to occur in patients with inflammatory myopathy (IM). Although high-resolutionimpedance manometry (HRIM) provides precise information regarding the pharyngeal pressure, it has not yetbeen used for assessing dysphagia in routine clinical practice. This study determined whether the results of HRIMfor evaluating deglutition disorders in patients with IM could reflect an abnormality that can’t be identified by avideo fluoroscopic swallowing study (VFSS). Methods: We reviewed both VFSS and HRIM results of nine patients with IM, four of whom presented with globussensation. Results: Cricopharyngeal muscle dysfunction was noted in all four patients with globus sensation, and the upperesophageal sphincter residual pressure (UESRP) was higher (≥8 mmHg) in the patients with pharyngeal residue. Using VFSS and HRIM, we demonstrated that dysphagia in patients with IM may arise owing to failed relaxation ofUES or decreased hyolaryngeal excursion. Conclusion: In conclusion, UES-RP values of ≥8 mmHg indicate the presence of pharyngeal residue and globussensation in patients with IM. HRIM provided a comprehensive assessment of the mechanisms of dysphagia, andHRIM facilitated recognizing subtle abnormalities in pharyngeal contraction and UES function. HRIM can overcome thelimitations of VFSS by allowing clinicians to perform objective measurements in patients with IM.
Abstract
Objective: Dysphagia has been reported to occur in patients with inflammatory myopathy (IM). Although high-resolutionimpedance manometry (HRIM) provides precise information regarding the pharyngeal pressure, it has not yetbeen used for assessing dysphagia in routine clinical practice. This study determined whether the results of HRIMfor evaluating deglutition disorders in patients with IM could reflect an abnormality that can’t be identified by avideo fluoroscopic swallowing study (VFSS). Methods: We reviewed both VFSS and HRIM results of nine patients with IM, four of whom presented with globussensation. Results: Cricopharyngeal muscle dysfunction was noted in all four patients with globus sensation, and the upperesophageal sphincter residual pressure (UESRP) was higher (≥8 mmHg) in the patients with pharyngeal residue. Using VFSS and HRIM, we demonstrated that dysphagia in patients with IM may arise owing to failed relaxation ofUES or decreased hyolaryngeal excursion. Conclusion: In conclusion, UES-RP values of ≥8 mmHg indicate the presence of pharyngeal residue and globussensation in patients with IM. HRIM provided a comprehensive assessment of the mechanisms of dysphagia, andHRIM facilitated recognizing subtle abnormalities in pharyngeal contraction and UES function. HRIM can overcome thelimitations of VFSS by allowing clinicians to perform objective measurements in patients with IM.
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