Interventions for dysphagia in long-term, progressive muscle disease

Jones, Katherine; Pitceathly, Robert D S; Rose, Michael R.; McGowan, Sue; Hill, Mary; Badrising, Umesh A.; Hughes, Tom

doi:10.1002/14651858.cd004303.pub4

Cited by 36 publications

(39 citation statements)

References 43 publications

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“…These problems result in increased mealtime with a consequent decrease in food intake, weight loss or an inability to gain weight; food inhalation into the airways with subsequent breathing problems and recurrent respiratory infections; and increased episodes of choking, coughing, and spluttering while eating resulting in embarrassment and psychological difficulties [6,12,22,23]. …”

Section: Undernutritionmentioning

confidence: 99%

“…Due to the muscle weakness that characterizes all NMDs, oral motor activities are impaired [1]. Furthermore, increased risk of aspiration predisposes to respiratory complications, and this is worsened by co-existing respiratory muscle weakness in patients with compromised airway defence mechanisms and severe coughing [4,23]. Dysphagia can also lead to social and psychological consequences with worsening quality of life that may be associated with loss of satiety, fear of choking, embarrassment, and social isolation secondary to coughing, spluttering, and prolonged feeding times [23].…”

Section: Dysphagiamentioning

confidence: 99%

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Nutritional Challenges in Duchenne Muscular Dystrophy

et al. 2017

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Neuromuscular diseases (NMDs) represent a heterogeneous group of acquired or inherited conditions. Nutritional complications are frequent in NMDs, but they are sometimes underestimated. With the prolongation of survival in patients with NMDs, there are several nutritional aspects that are important to consider, including the deleterious effects of overnutrition on glucose metabolism, mobility, and respiratory and cardiologic functions; the impact of hyponutrition on muscle and ventilatory function; constipation and other gastrointestinal complications; chewing/swallowing difficulties with an increased risk of aspiration that predisposes to infectious diseases and respiratory complications; as well as osteoporosis with an associated increased risk of fractures. The aim of this review is to provide a comprehensive analysis of the nutritional aspects and complications that can start in children with Duchenne muscular dystrophy (DMD) and increase with ageing. These aspects should be considered in the transition from paediatric clinics to adult services. It is shown that appropriate nutritional care can help to improve the quality of life of DMD patients, and a multidisciplinary team is needed to support nutrition challenges in DMD patients. However, studies on the prevalence of overnutrition and undernutrition, gastrointestinal complications, infectious diseases, dysphagia, and reduced bone mass in the different types of NMDs are needed, and appropriate percentiles of weight, height, body mass index, and body composition appear to be extremely important to improve the management of patients with NMD.

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Section: Undernutritionmentioning

confidence: 99%

Section: Dysphagiamentioning

confidence: 99%

Nutritional Challenges in Duchenne Muscular Dystrophy

et al. 2017

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“…Impaired swallow, also called dysphagia, is a frequent symptom in NMD that occurs in 34.9% to 80% of patients, depending on the disease age group and the severity . Prevalence in paediatric patients with neuromuscular diseases (pNMD) seems to be similar to adult patients .…”

mentioning

confidence: 99%

“…Prevalence in paediatric patients with neuromuscular diseases (pNMD) seems to be similar to adult patients . However, precise estimates of the prevalence remain difficult to determine, owing to underestimation, lack of standardized assessment procedures, and inconsistency in the definition of dysphagia, especially in children . A previous study showed that in patients with NMD the oral phase of swallowing is the most compromised, followed by the pharyngeal phase .…”

mentioning

confidence: 99%

“…8 Impaired swallow, also called dysphagia, is a frequent symptom in NMD that occurs in 34.9% to 80% of patients, depending on the disease age group and the severity. 1,5,[9][10][11][12][13][14][15] Prevalence in paediatric patients with neuromuscular diseases (pNMD) seems to be similar to adult patients. 2,9,[16][17][18] However, precise estimates of the prevalence remain difficult to determine, owing to underestimation, lack of standardized assessment procedures, and inconsistency in the definition of dysphagia, especially in children.…”

mentioning

confidence: 99%

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Screening and evaluation tools of dysphagia in children with neuromuscular diseases: a systematic review

Audag

Goubau

Toussaint³

et al. 2016

Develop Med Child Neuro

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Cricopharyngeal Myotomy in Inclusion Body Myositis: Comparison of Endoscopic and Transcervical Approaches

et al. 2021

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Objective: Inclusion body myositis (IBM) is a progressive inflammatory myopathy with dysphagia as a debilitating sequalae. Otolaryngologists are consulted for surgical candidacy when there are findings of cricopharyngeal dysfunction. We aim to compare transcervical cricopharyngeal myotomy (TCPM) versus endoscopic cricopharyngeal myotomy (ECPM) in the IBM population with particular focus on objective swallow study outcomes, complications, and recurrence rates.Methods: A retrospective cohort study was performed on IBM patients who underwent TCPM or ECPM in the Department of Otolaryngology at a tertiary academic center with a high volume IBM referral base. Videofluoroscopic swallow studies, Eating Assessment Tool (EAT-10), Reflux Symptom Index (RSI), and Functional Outcome Swallowing Scale (FOSS) were collected at preoperative and follow-up visits. Baseline patient characteristics, intraoperative data, and postoperative course were recorded.Results: Forty-one patients were identified (18 TCPM; 23 ECPM). There was no significant difference in the recurrence rates, complications, hospitalization length, operative time, or return to preoperative diet between approaches. For the 12 patients (11 ECPM; 1 TCPM) that had subjective swallow data, there was a statistically significant difference in the pre and postoperative scores for EAT-10, RSI, and FOSS (P < .05). There was a statistically significant improvement in the degree of narrowing between pre and postoperative imaging for both approaches (P < .05).Conclusion: Both TCPM and ECPM are safe approaches for the management of dysphagia in patients with IBM with objective evidence of cricopharyngeal dysfunction. Cricopharyngeal myotomy is a durable technique that has demonstrated improved subjective and objective outcomes in this patient population.

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Interventions for dysphagia in long-term, progressive muscle disease

Cited by 36 publications

References 43 publications

Nutritional Challenges in Duchenne Muscular Dystrophy

Nutritional Challenges in Duchenne Muscular Dystrophy

Screening and evaluation tools of dysphagia in children with neuromuscular diseases: a systematic review

Cricopharyngeal Myotomy in Inclusion Body Myositis: Comparison of Endoscopic and Transcervical Approaches

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