Assessment of oropharyngeal swallowing dysfunction in myasthenia gravis patients presenting with difficulty in swallowing

Kumai, Yoshihiko; Miyamoto, Takumi; Matsubara, Keigo; Samejima, Yasuhiro; Yamashita, Satoshi; Ando, Yumiko; Orita, Yorihisa

doi:10.1016/j.anl.2018.10.004

Cited by 7 publications

(10 citation statements)

References 17 publications

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“…Although the usefulness of the flexible videoendoscopic method of swallowing assessment has been widely reported by Langmore and colleagues since 1988, there are few endoscopic scoring methods to evaluate swallowing function [16]. The endoscopic method of scoring swallowing function which was used in the present study evaluates four parameters (salivary pooling at the vallecula and piriform sinuses, induction of the glottic closure reflex by touching the epiglottis or arytenoids with the endoscope, swallowing reflex initiation assessed by ''white-out'' timing, and pharyngeal clearance after swallowing blue-dyed water), scoring each from 0 to 3 on a 4-point scale (0, normal; 1, mildly impaired; 2, moderately impaired; 3, severely impaired) [6,7,9]. Although the efficacy of this simple scoring method has been shown in patients with dysphagia due to various cerebrovascular and neuromuscular diseases, no previous reports focused on head and neck cancer patients [5][6][7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

“…The endoscopic method of scoring swallowing function which was used in the present study evaluates four parameters (salivary pooling at the vallecula and piriform sinuses, induction of the glottic closure reflex by touching the epiglottis or arytenoids with the endoscope, swallowing reflex initiation assessed by ''white-out'' timing, and pharyngeal clearance after swallowing blue-dyed water), scoring each from 0 to 3 on a 4-point scale (0, normal; 1, mildly impaired; 2, moderately impaired; 3, severely impaired) [6,7,9]. Although the efficacy of this simple scoring method has been shown in patients with dysphagia due to various cerebrovascular and neuromuscular diseases, no previous reports focused on head and neck cancer patients [5][6][7][8][9][10]. Surgery for advanced head and neck cancer causes oropharyngeal deformation with restriction of movement of the transferred flap, and chemoradiation causes disorders of laryngeal elevation and sensation accompanied by xerostomia and dysgeusia [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…However, the problem with FEES is that the evaluation method is complicated, require expensive seminar, without an established simple scoring method. The scoring method of endoscopic swallowing evaluation proposed by Hyodo and colleagues of the Japanese Society of Otorhinolaryngology in 2010 is quite simple and has been widely accepted and used in Japan [4][5][6][7][8][9][10]. However, since this scoring method was initially intended for assessment of dysphagia in elderly people and patients with cerebrovascular or neuromuscular diseases, its usefulness in the assessment of swallowing function after treatment in head and neck cancer patients has not been established.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Simple Endoscopic Method of Scoring Swallowing Function After Treatment in Advanced Head and Neck Cancer Patients

Ohkoshi

Ogawa

Kato

et al. 2021

Indian J Otolaryngol Head Neck Surg

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The aim of this prospective, observational study was to evaluate the effectiveness of a simple endoscopic method for scoring swallowing function after treatment of advanced head and neck cancer patients. A prospective, observational study was conducted involving 60 patients who had undergone surgery or chemoradiation for advanced head and neck cancer. Endoscopic score of swallowing function, penetration aspiration scale (PAS) score measured by videofluorography, and functional oral intake scale (FOIS) score were recorded, and their correlations were examined. There was a positive correlation between endoscopic and PAS scores. Patients with endoscopic scores of 4 points or more had significantly higher PAS scores and lower FOIS scores than those with scores of 3 points or less. These positive correlations were found only in patients who underwent surgery, and not those who received chemoradiation. This study showed the effectiveness of the simple endoscopic method for scoring swallowing function in patients after surgery for advanced head and neck cancers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Simple Endoscopic Method of Scoring Swallowing Function After Treatment in Advanced Head and Neck Cancer Patients

Ohkoshi

Ogawa

Kato

et al. 2021

Indian J Otolaryngol Head Neck Surg

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“…The disorder underlying this disease is the presence of antibodies that attack the nicotinic receptors in the neuromuscular junction. 2,5 The prevalence of MG is about 20 cases per 100,000 lives. The highest incidence occurs in women over 40 years and even higher in men over 50 years.…”

Section: Discussionmentioning

confidence: 99%

“…Only 6% cases manifested dysphagia as a single symptom of MG. 2 Patients with dysphagia due to MG need appropriate management involving multidisciplinary approach in order to obtain a optimal result. 2,5,6 Assessment of dysphagia includes the existence of impaired swallowing function, the level of anatomy involved, and the underlying disease. Management of MG has several therapeutic modalities that can be given based on the severity and onset of MG. 7 The purpose of this paper was to report two cases of dysphagia in MG and their management using multidisciplinary approach.…”

Section: Introductionmentioning

confidence: 99%

Dysphagia as presenting symptom of myasthenia gravis : a case series of successful outcome in multidisciplinary approach

2020

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Dysphagia can be caused by mechanic or neurologic disorders. Neurologic dysphagia is commonly related to cerebrovascular disease, parkinson disease, amyotropic lateral sclerosis, tardive dyskinesia, and myasthenia gravis (MG). About 15-40% dysphagia occurred in MG generalized type. Only 6% MG with dysphagia were reported as a single symptom. The case reports aimed to demonstrate the role of otolaryngologist in multidisciplinary approach of the MG management. Two cases of MG were reported. First case was a 33 years old woman with moderate MG generalized type with ocular, dysphagia, and disarthria symptoms and second case was a 46 years old man with acute severe MG with crisis. Management therapy was applied according to onset and severity of MG. Acetylcholinesterase (AChE) and corticosteroid were administered for the first case, whereas therapeutic plasma exchange (TPE) for second case. In conclusion, disfagia in MG can be accompanied with other symptom, therefore its management should be based on the severity in order to give a positive result. ABSTRAK Disfagia dapat disebabkan oleh gangguan mekanik maupun motorik. Disfagia akibata gangguan saraf umumnya dikaitkan dengan penyakit cerebrovaskuler, parkinson, amyotropic lateral sclerosis, tardive dyskinesia dan miastenia gravis (MG). Sekitar 15-40% disfagia terjadi pada MG tipe generalisata. Hanya 6% disfagia dilaporkan sebagai gejala tunggal pada MG. Laporan kasus ini bertujuan memberikan gambaran peran ahli THT dalam penatalaksanaan MG secara multidisiplin. Dua kasus disfagia akibat MG telah dilaporkan. Kasus pertama adalah wanita berumur 33 tahun dengan MG tipe generalisata derajat sedang dengan gejala ocular, disfagia dan disartria. Kasus kedua seorang seorang pria berumur 46 tahun dengan MG akut berat dengan krisis. Penatalaksanaan terapi dilakukan menurut onset dan keparahan MG. Asetilkolinesterase (AChE) dan kortikosteroid diberikan untuk kasus pertama, sedangkan terapi pertukaran plasma (TPP) untuk kasus kedua. Dapat disimpulkan, disfagia pada MG dapat desertai gejala lain sehingga tatalaksananya harus diberikan sesuai derajat keparahan penyakit agar memberikan respon yang baik.

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Myasthenia gravis, respiratory function, and respiratory tract disease

Gilhus

2023

J Neurol

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Myasthenia gravis (MG) is characterized by muscle weakness caused by autoantibodies that bind to the postsynaptic membrane at the neuromuscular junction and impair acetylcholine receptor function. Weakness of respiratory muscles represents the most severe MG manifestation, and 10–15% of all patients experience an MG crisis with the need of mechanical ventilatory support at least once in their life. MG patients with respiratory muscle weakness need active immunosuppressive drug treatment long term, and they need regular specialist follow-up. Comorbidities affecting respiratory function need attention and optimal treatment. Respiratory tract infections can lead to MG exacerbations and precipitate an MG crisis. Intravenous immunoglobulin and plasma exchange are the core treatments for severe MG exacerbations. High-dose corticosteroids, complement inhibitors, and FcRn blockers represent fast-acting treatments that are effective in most MG patients. Neonatal myasthenia is a transient condition with muscle weakness in the newborn caused by mother’s muscle antibodies. In rare cases, treatment of respiratory muscle weakness in the baby is required.

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Assessment of oropharyngeal swallowing dysfunction in myasthenia gravis patients presenting with difficulty in swallowing

Cited by 7 publications

References 17 publications

Simple Endoscopic Method of Scoring Swallowing Function After Treatment in Advanced Head and Neck Cancer Patients

Simple Endoscopic Method of Scoring Swallowing Function After Treatment in Advanced Head and Neck Cancer Patients

Dysphagia as presenting symptom of myasthenia gravis : a case series of successful outcome in multidisciplinary approach

Myasthenia gravis, respiratory function, and respiratory tract disease

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