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The presence of dysphagia in patients with cerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS): a subjective and objective study

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Abstract

Purpose

The aim of this study was to determine the prevalence of dysphagia in patients with cerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS), characterizing this condition, both in its objective dimension and in terms of quality of life (QoL).

Methods

A cross-sectional study was developed in 11 patients diagnosed of CANVAS. In all patients, clinical records were reviewed and the Eating assessment tool 10 (EAT-10) was performed as screening of oropharyngeal dysphagia. To evaluate the QoL impairment secondary to dysphagia, we applied the swallowing quality of life questionnaire (SWAL-QOL) and the MD Anderson Dysphagia Inventory (MDADI). To evaluate the deglutition mechanisms impaired, two objective-instrumental studies were performed: the volume-viscosity swallow test (V-VST) and the fiberoptic endoscopic evaluation of swallowing (FEES).

Results

82% of the patients presented an abnormal EAT-10 score. A correlation was found between the EAT-10 and MDADI and between both QoL questionnaires. After the FEES and V-VST analysis, all 11 patients presented some degree of swallow effectiveness impairment, and most of them safety alterations as well.

Conclusion

CANVAS remains an underestimated and underdiagnosed condition and the prevalence of swallowing disorders in those patients is higher than expected. Despite the possibility that EAT-10 works as a useful screening test to predict the results in the QoL questionnaires, the absence of correlation between QoL test and instrumental results suggests that to properly evaluate the patients swallowing status, objective instrumental procedures must be conducted.

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Availability of data and material

Authors declare that all data and materials are available for review.

Code availability

Statistical analyses were performed using IBM SPSS statistics software version 22 for MacOS.

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Funding

No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Otolaryngology, Hospital Universitario Central de Asturias, IUOPA, University of Oviedo, Centro de Investigación Biomédica en Red de Cancer (CIBERONC), Oviedo, Spain

    Rodrigo Casanueva, Fernando López, Maria Costales, Eva Villanueva, Jose L. Llorente & Cesar Alvarez Marcos

  2. Instituto de Investigación Sanitaria del Principado de Asturias, Centro de Investigación Biomédica en Red de Cancer (CIBERONC), ISCIII, Oviedo, Spain

    Fernando López, Maria Costales, Jose L. Llorente & Cesar Alvarez Marcos

  3. Instituto Universitario de Oncologia del Principado de Asturias, University of Oviedo, Oviedo, Spain

    Fernando López, Maria Costales, Jose L. Llorente & Cesar Alvarez Marcos

  4. University of Oviedo, Oviedo, Asturias, Spain

    Alicia Ordas

Authors
  1. Rodrigo Casanueva
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  2. Fernando López
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  3. Maria Costales
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  4. Alicia Ordas
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  5. Eva Villanueva
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  6. Jose L. Llorente
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  7. Cesar Alvarez Marcos
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Corresponding author

Correspondence to Rodrigo Casanueva.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. The project was approved by the Research Ethics Committee of Principado de Asturias (2020.169).

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Written informed consent was obtained from patients who participated in this study.

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Publication consent was obtained from the patients who participated in this study.

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Casanueva, R., López, F., Costales, M. et al. The presence of dysphagia in patients with cerebellar ataxia, neuropathy and vestibular areflexia syndrome (CANVAS): a subjective and objective study. Eur Arch Otorhinolaryngol 278, 2585–2592 (2021). https://doi.org/10.1007/s00405-020-06534-2

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  • DOI: https://doi.org/10.1007/s00405-020-06534-2

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