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Vocal fold motion impairment in patients with multiple system atrophy: evaluation of its relationship with swallowing function

Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Japan

Correspondence to:
Correspondence to:
Dr Higo, Department of Otolaryngology, Faculty of Medicine, University of Tokyo 3–1, Hongo 7-chome, Bunkyo-ku, Tokyo 113-8655, Japan;
rhigo-tky{at}umin.ac.jp

Objective: To elucidate the relationship between VFMI and dysphagia in MSA.

Methods: We evaluated swallowing function of 36 MSA patients with and without VFMI, by videofluoroscopy, and investigated the relationship between VFMI and pharyngeal swallowing function.

Results: VFMI was found in 17 patients (47.2%). Patients with VFMI had advanced severity of the disease. Although there was a tendency for bolus stasis at the pyriform sinus and the upper oesophageal sphincter opening to be more involved in patients with VFMI, statistical analysis did not show significant differences in swallowing function of MSA patients between with and without VFMI. In contrast, patients who underwent a tracheotomy ultimately required tube feeding or a laryngectomy.

Conclusions: Appearance of VFMI is a sign of disease progression but does not necessary mean patients should change their way of taking nutrition. However, MSA patients who need a tracheotomy might have advanced to a high-risk group for dysphagia. Appropriate evaluation and treatment for VFMI and dysphagia are required to maintain patients’ quality of life in MSA.

Keywords: dysphagia; multiple system atrophy; videofluoroscopy; vocal fold motion impairment

Abbreviations: MSA, multiple system atrophy; NA, nucleus ambiguous; PD, Parkinson’s disease; PS, pyriform sinus; UOS, upper oesophageal sphincter; VF, videofluoroscopy; VFMI, vocal fold motion impairment

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