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Dysphagia

, Volume 21, Issue 4, pp 280–286 | Cite as

Assessment of Swallowing by Oropharyngoesophageal Scintigraphy in Patients with Amyotrophic Lateral Sclerosis

  • Bruno FattoriEmail author
  • Mariano Grosso
  • Paolo Bongioanni
  • Andrea Nacci
  • Renza Cristofani
  • Abedallatif AlSharif
  • Rosaria Licitra
  • Fabio Matteucci
  • Bruno Rossi
  • Domenico Rubello
  • Francesco Ursino
  • Giuliano Mariani
Article

Abstract

Amyotrophic lateral sclerosis (ALS) is the most common degenerative motor neuron disease in adults, and dysphagia is one of its most frequent and disabling symptoms. Oropharyngoesophageal scintigraphy (OPES) permits a functional and semiquantitative study of the various stages of swallowing. We studied 28 ALS patients (12 females and 16 males; mean age = 63.57 ± 10.39 yr SD), who were clinically rated against the ALSFRS scale (Amyotrophic Lateral Sclerosis Functioning Rating Scale) and underwent OPES with 99mTc-nanocolloid using either a liquid or a semisolid bolus. The semiquantitative parameters we analyzed were Oral Transit Time (OTT), Pharyngeal Transit Time (PTT), Esophageal Transit Time (ETT), Retention Index (RI), and Esophageal Emptying Rate (EER10s). Hence, the OPES performed with a semisolid bolus produced a higher proportion of pathologic values for the swallowing variables than when liquid bolus was used. Analyzed by grouping the patients into classes according to their bulbar ALSFRS scores, we found a significant increase in the OTT (p < 0.005), PTT (p < 0.02), and Oropharyngeal Retention Index (OPRI) (p < 0.0004) variables in ALS patients with more severe bulbar involvement. OPES has turned out to be a very important examination for detecting tracheal-bronchial inhalation and it also offers the possibility of acquiring a semiquantitative evaluation of the amount of food inhaled. In our experience, OPES in patients with ALS has been easy to use, economic, well tolerated, and capable of supplying precise indications with regard to the extent of the swallowing disorder, which permits a better clinical definition of the ALS patient.

Keywords

Amyotrophic lateral sclerosis Scintigraphy Dysphagia Deglutition Deglutition disorders 

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Copyright information

© Springer Science+Business Media, Inc. 2007

Authors and Affiliations

  • Bruno Fattori
    • 1
    Email author
  • Mariano Grosso
    • 2
  • Paolo Bongioanni
    • 3
  • Andrea Nacci
    • 1
  • Renza Cristofani
    • 4
  • Abedallatif AlSharif
    • 2
    • 6
  • Rosaria Licitra
    • 3
  • Fabio Matteucci
    • 1
  • Bruno Rossi
    • 3
  • Domenico Rubello
    • 5
  • Francesco Ursino
    • 1
  • Giuliano Mariani
    • 2
  1. 1.Department of Neuroscience, ENT Unit University of PisaPisaItaly
  2. 2.Regional Center of Nuclear MedicineUniversity of PisaPisaItaly
  3. 3.Department of Neuroscience, Neurorehabilitation Unit University of PisaPisaItaly
  4. 4.Department of Experimental Pathology, Medical Biotechnology, Infective Disease and EpidemiologyUniversity of PisaPisaItaly
  5. 5.Nuclear Medicine Service“S. Maria della Misericordia” HospitalRovigoItaly
  6. 6.Department of Internal Medicine, Division of Radiology and Nuclear MedicineJordan University HospitalAmmanJordan

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