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Digital cineradiographic study of swallowing in patients with amyotrophic lateral sclerosis

Studio dinamico della deglutizione in un gruppo di pazienti affetti da sclerosi laterale amiotrofica

  • Gastrointestinal Radiology Radiologia Gastrointestinale
  • Published:
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Abstract

Purpose

This study was performed to evaluate the usefulness of digital cineradiography in detecting swallowing disorders in dysphagic patients affected by amyotrophic lateral sclerosis (ALS) with a view to planning an adequate therapeutic approach.

Material and methods

From January 2005 to September 2006, 23 patients (10 men and 13 women; mean age 41.3±8.6 years) affected by ALS were evaluated with digital cineradiography to assess the grade of dysphagia. All patients were classified using the Hillel ALS Severity Scale (ALSSS). All examinations were performed with radiocontrolled equipment provided with a digital C-arm.

Results

The cineradiographic technique enabled us to differentiate patients with disorders of the oral (17/23) and/or pharyngeal (19/23) swallowing phase from those without swallowing dysfunction (4/23). In 14/23 patients, passage of contrast medium into the upper airways was observed during swallowing, whereas in 5/23 cases, aspiration of contrast medium into the lower airways was recorded.

Conclusions

The videofluoroscopic swallowing study has high diagnostic capabilities in the evaluation of swallowing disorders, as it is able to identify the degree and causes of impairment. In addition, the study proved useful for planning speech therapy and for follow-up in patients with ALS.

Riassunto

Obiettivo

Scopo del nostro lavoro è quello di valutare il ruolo della videofluorografia (VDFG) nell’identificazione delle alterazioni deglutitorie dei pazienti disfagici affetti da sclerosi laterale amiotrofica (SLA), anche al fine di programmare una adeguata pianificazione terapeutica.

Materiali e metodi

Dal gennaio 2005 al settembre 2006, 23 pazienti (10 uomini e 13 donne; età media 41,3±8,6 anni) affetti da SLA e classificati secondo la classificazione ALS Severity Scale (ALSSS) di Hillel sono stati sottoposti a studio videofluorografico della deglutizione. Tutti gli esami sono stati eseguiti utilizzando un apparecchio telecomandato con arco a C digitale.

Risultati

La tecnica videofluorografica utilizzata ha permesso di differenziare i pazienti con alterazioni deglutitorie, 17/23 con alterazioni della fase orale e 19/23 con alterazioni della fase faringea (19/23 pazienti), da quelli che non presentavano alterazioni 4/23. In 14/23 pazienti sono stati evidenziati fenomeni di penetrazione del bolo in laringe, ed in 5/23 pazienti fenomeni di aspirazione del bolo al di sotto del piano glottico.

Conclusioni

Lo studio videofluorografico della deglutizione è una tecnica dotata di elevata capacità diagnostica per la valutazione dei deficit deglutitori, essendo in grado di identificarne il grado di compromissione e le cause determinanti. Lo studio dinamico della deglutizione si è inoltre dimostrato utile nell’approccio alla terapia logopedica e nel follow-up dei pazienti affetti da SLA.

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Authors and Affiliations

  1. Sezione di Scienze Radiologiche del Dipartimento di Biotecnologie Mediche e Medicina Legale, via del Vespro 127, I-90100, Palermo, Italy

    G. Lo Re, M. Galia, L. La Grutta, S. Russo, G. Runza, A. Taibbi, T. D’Agostino, V. Lo Greco, T. V. Bartolotta, M. Midiri, A. E. Cardinale, M. De Maria & R. Lagalla

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  1. G. Lo Re
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  2. M. Galia
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  3. L. La Grutta
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  4. S. Russo
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  5. G. Runza
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  6. A. Taibbi
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  7. T. D’Agostino
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  8. V. Lo Greco
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  9. T. V. Bartolotta
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  11. A. E. Cardinale
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  12. M. De Maria
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  13. R. Lagalla
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Correspondence to G. Lo Re.

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Lo Re, G., Galia, M., La Grutta, L. et al. Digital cineradiographic study of swallowing in patients with amyotrophic lateral sclerosis. Radiol med 112, 1173–1187 (2007). https://doi.org/10.1007/s11547-007-0214-9

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  • DOI: https://doi.org/10.1007/s11547-007-0214-9

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