Management of Dysphagia in Inclusion Body Myositis

In Response to Regarding Cricopharyngeal Myotomy in IBM: Comparison of Endoscopic and Transcervical Approaches

“…Two of the most critical aspects that must be considered when determining surgical candidacy are bolus propulsion during the pharyngeal phase and esophageal motility. 5 As demonstrated in our study, mild to moderate pharyngeal weakness in the early stages of disease can be successfully overcome with CP myotomy if a CP bar is present; however, severe pharyngeal weakness without hypopharyngeal pooling is a contraindication to surgical intervention. Interdisciplinary review between the speech language pathologist, radiologist, neurologist, and physical medicine and rehabilitation teams to review these factors is critical.…”

Dysphagia in patients with inclusion body myositis

“…Myopathic patients with sluggish, altered pharyngeal musculature will likely exhibit dysphagia. The incidence of dysphagia in IBM is 40% in large patient series 3–5 . Our series reflects greater than an 80% incidence of dysphagia.…”

Cricopharyngeal bar and dermatomyositis: A cause of rapidly progressive dysphagia

“…Interestingly, when biopsied, CPBs in IIM patients tend to show an inflammatory infiltrate (Table 2), which can be consistent with the underlying myositic process 3,11–14,16,18 . Several authors have observed patients with inclusion body myositis, and found histological features in the cricopharyngeal biopsies that resembled inclusion body myositis 13,14,18 .…”