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Diagnosis

 

Videofluorography swallow study in patients with systemic sclerosis: correlation with clinical and radiological features

1, 2, 3, 4, 5, 6, 7, 8, 9, 10

 

  1. Clinica Medica, Dipartimento di Medicina Interna, AOU Ospedali Riuniti di Ancona, Italy.
  2. SOD Radiologia Pediatrica e Specialistica, Dipartimento di Scienze Radiologiche, AOU Ospedali Riuniti di Ancona, Italy.
  3. Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy.
  4. Dipartimento di Scienze Cliniche e Specialistiche, Università Politecnica delle Marche, Ancona, Italy.
  5. Dipartimento di Scienze Cliniche e Specialistiche, Università Politecnica delle Marche, Ancona, Italy.
  6. Dipartimento di Scienze Cliniche e Specialistiche, Università Politecnica delle Marche, Ancona, Italy.
  7. Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy.
  8. Clinica Medica, Dipartimento di Medicina Interna, AOU Ospedali Riuniti di Ancona, Italy.
  9. Clinica Medica, Dipartimento di Medicina Interna, AOU Ospedali Riuniti di Ancona e Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy. a.gabrielli@staff.univpm.it
  10. SOD Radiologia Pediatrica e Specialistica, Dipartimento di Scienze Radiologiche, AOU Ospedali Riuniti di Ancona and Dipartimento di Scienze Cliniche e Specialistiche, Università Politecnica delle Marche, Ancona, Italy.

CER12583
2019 Vol.37, N°4 ,Suppl.119
PI 0108, PF 0114
Diagnosis

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PMID: 31587696 [PubMed]

Received: 10/07/2019
Accepted : 12/09/2019
In Press: 03/10/2019
Published: 03/10/2019

Abstract

OBJECTIVES:
The aim of our study was to assess the role of videofluorography (VFG) in the evaluation of swallowing and oesophageal peristalsis in patients with systemic sclerosis (SSc).
METHODS:
From June 2014 to September 2017, 55 consecutive SSc patients, defined according to the 2013 ACR/EULAR classification criteria, underwent VFG study using a remote-controlled digital device. In order to evaluate possible abnormalities, 18 dynamic parameters were chosen, dividing the act of swallowing into three phases: oral, pharyngeal and oesophageal phases. The following dynamic radiological findings were considered: veil motility in phonation, leakage, drooling, salivation and presence of residues in the oral cavity, pharyngeal residues, penetration, aspiration, altered motility of the upper oesophageal sphincter, efficacy of primary peristaltic contractions, oesophageal clearance capacity, reflux, oesophagitis and motility of the lower oesophageal sphincter.
RESULTS:
The VFG study was well tolerated in all patients. Dysfunctions of oesophageal motility were common and included abnormal motility of UES (12.7%) and LES (76.4%), inadequate primary peristalsis (52.7%), abnormal secondary peristalsis (29.1%) and non-peristaltic contractions (40%). A defective oesophageal clearance was observed in 69.4% of patients. Moreover, most patients presented signs of oesophageal reflux (63.6%), oesophagitis (81.8%) and hiatal hernia (80%). Pharyngeal abnormalities were less common and involved up to 50% of patients. Oesophageal dysfunction and defective clearance were associated with dcSSc and pulmonary involvement.
CONCLUSIONS:
The VFG study is a useful technique for the morphological and functional evaluation of swallowing in SSc patients.

Rheumatology Article