Cricopharyngeal bar on videofluoroscopy: high specificity for inclusion body myositis

Taira, Kenichiro; Yamamoto, Toshiyuki; Mori‐Yoshimura, Madoka; Sajima, Kazuaki; Takizawa, Hotake; Shinmi, Jun; Oya, Yasushi; Nishino, Ichizo; Takahashi, Yūji

doi:10.1007/s00415-020-10241-7

Cited by 15 publications

(17 citation statements)

References 51 publications

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“…Another study found that a myofascialdominant involvement on WB-MRI seems to be a risk factor for RP-ILD (51). In CADM, the elevation of Cy-fra21.1 was correlated with ILD, while CEA and NSE with acute or subacute forms of ILD (52) (56). Moreover, the presence of CPB on VFS examination in IBM patients was a risk factor for aspiration pneumonia (57).…”

Section: Take-home Messagesmentioning

confidence: 99%

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Idiopathic inflammatory myopathies: one year in review 2021

Cardelli

Zanframundo

Cometi

et al. 2022

Clinical and Experimental Rheumatology

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Idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of rare and complex connective tissue diseases, mainly characterised by inflammatory involvement of skeletal muscles. Several other organs may be affected, particularly lungs, heart, skin, gastrointestinal tract and joints, often determining the morbidity and mortality associated with these autoimmune disorders. The course is generally chronic and the onset subacute. This latter aspect, together with the rarity of these conditions, can result in a clinical challenge for the physician with a considerable diagnostic delay. The scientific literature makes continuous advances in the understanding of these diseases, in particular with regards to the pathogenesis, serological findings, diagnostic strategies and therapeutic approaches. The aim of this review is to highlight the most relevant literature contributions published on this topic over the last year.

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Section: Take-home Messagesmentioning

confidence: 99%

“…• Specific NVC alterations are associated with different clinical phenotypes (53,54). • Cricopharyngeal bar on VFS has a high specificity for IBM and seem to be a risk factor for aspiration pneumonia (56,57).…”

Section: Nailfold Videocapillaroscopy (Nvc)mentioning

confidence: 99%

Idiopathic inflammatory myopathies: one year in review 2021

Cardelli

Zanframundo

Cometi

et al. 2022

Clinical and Experimental Rheumatology

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“…The cervical esophagus portion of the UES has a length of 1–2 cm, presenting a transitional anatomic structure between the cricopharyngeal muscle and the adjacent lower section of the esophagus and demonstrating unique histologic features and the presence of circular muscle fibers [ 38 ]. This cervical esophagus segment is located between C6 and C7 [ 38 ], at a level just below the cricopharyngeal muscle and the cricopharyngeal bar (reported at various levels, from C4 to C6) [ 39 , 40 ].…”

Section: Length Of Ues Dysfunctionmentioning

confidence: 99%

“…Under most conditions, the targets of UES botulinum toxin injection are the cricopharyngeus (level with the cricoid cartilage) and the upper part of the cervical esophagus (posterior to the trachea, approximately between C6 and C7 [ 38 ]). A cricopharyngeal bar viewed by a barium study is usually located between C4 and C6 [ 39 , 40 ]. The cervical esophagus in the lower neck deviates to the left and is closer to the carotid sheath and thyroid gland on the left side than on the right side [ 53 ].…”

Section: Guiding Techniques For Botulinum Toxin Injectionmentioning

confidence: 99%

Botulinum Toxin Injection for the Treatment of Upper Esophageal Sphincter Dysfunction

Wei

2022

Toxins

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Dysphagia associated with upper esophageal sphincter (UES) dysfunction remarkably affects the quality of life of patients. UES injection of botulinum toxin is an effective treatment for dysphagia. In comparison with skeletal muscles of the limb and trunk, the UES is a special therapeutic target of botulinum toxin injection, owing to its several anatomical, physiological, and pathophysiological features. This review focuses on (1) the anatomy and function of the UES and the pathophysiology of UES dysfunction in dysphagia and why the entire UES rather than the cricopharyngeal muscle before/during botulinum toxin injection should be examined and targeted; (2) the therapeutic mechanisms of botulinum toxin for UES dysfunction, including the choice of injection sites, dose, and volume; (3) the strengths and weaknesses of guiding techniques, including electromyography, ultrasound, computed tomography, and balloon catheter dilation for botulinum toxin injection of the UES.

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“…The findings of similar abnormalities seen on VFS in IBM reported by other studies [14,28] and the high incidence of detecting dysphagia by VFS (up to 72-79%) [14,28] suggest that VFS is a reproducible and reliable diagnostic study. A study by Taira et al demonstrated that against muscular disorders, the finding of the cricopharyngeal bar (CPB) on VFS in IBM narrows the upper esophagus, like a bottleneck, with a sensitivity of 33% (17/52) yet a high specificity of 96% (264/274), suggesting the presence of CPB on VFS may be highly indicative of IBM and showing a higher frequency of obstruction-related dysphagia [29]. A limitation of VFS however, is the significant radiation exposure [18].…”

Section: Diagnostic Challengesmentioning

confidence: 99%

Dysphagia in Inclusion Body Myositis, A Disease of the Elderly

Goyal¹,

Mozaffar²

2021

OBM Geriatrics

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Inclusion body myositis is one of the most common acquired myopathies seen in the aging population. The muscle weakness is of insidious onset, frequently starting in the legs, but over time gradually progresses to eventually involve all skeletal muscles of the limbs, face, swallowing and respiratory muscles, leading to significant morbidity and mortality. Complications resulting from dysphagia are the leading cause of poor quality of life and mortality, while highly prevalent, are still underappreciated and underrecognized. This review highlights the importance of understanding the urgent need for recognizing and improving the evaluation, outcome measures and therapeutic options of dysphagia in inclusion body myositis patients.

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Cricopharyngeal bar on videofluoroscopy: high specificity for inclusion body myositis

Cited by 15 publications

References 51 publications

Idiopathic inflammatory myopathies: one year in review 2021

Idiopathic inflammatory myopathies: one year in review 2021

Botulinum Toxin Injection for the Treatment of Upper Esophageal Sphincter Dysfunction

Dysphagia in Inclusion Body Myositis, A Disease of the Elderly

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