Abstract
Purpose
The authors sought to determine the role of video ultrasonography (VUS) in the diagnostic assessment of dysphagia in patients with amyotrophic lateral sclerosis (ALS).
Materials and methods
Nine patients underwent simultaneous static and dynamic VUS examination and videofluoroscopy (VFS) of swallowing.
Results
At the static phase, VUS showed 5/9 patients had lingual atrophy. Abnormal bolus position was observed in 6/9 patients at VUS and 3/9 at VFS. Both techniques identified an inability to keep the bolus in the oral cavity in 4/9 patients. At the dynamic phase, reduced lingual movement was observed in 5/9 patients at VUS and 2/9 at VFS. Disorganised tongue movement was seen in 3/9 patients at VUS and in 2/9 at VFS. Fragmented swallowing was only visualised at VUS. Stagnation of ingested material was never visualised at VUS, whereas it was clearly depicted in 2/9 patients at VFS.
Conclusions
VUS can be integrated into the diagnostic protocol for evaluating swallowing in patients with ALS, as it has higher sensitivity than VFS in assessing the dynamic factors that represent the early signs of dysphagia.
Riassunto
Obiettivo
Scopo di questo lavoro è stato stabilire quale ruolo abbia l’ecovideografia (EVG) nel protocollo diagnostico dei pazienti disfagici con sclerosi laterale amiotrofica (SLA).
Materiali e metodi
Nove pazienti sono stati sottoposti contestualmente ad esame con videofluoroscopia (VFS) ed EVG (studio statico e dinamico) della deglutizione.
Risultati
Per quanto riguarda la fase statica, all’EVG 5 pazienti presentavano atrofia linguale. La posizione anomala del bolo è stata osservata in 6/9 pazienti all’EVG e in 3/9 alla VFS. Quattro pazienti presentavano incapacità a trattenere il bolo nella cavità orale in entrambe le metodiche. Per quanto riguarda la fase dinamica, il movimento linguale ridotto è stato visualizzato in 5/9 pazienti all’EVG e in 2/9 alla VFS. La disorganizzazione del movimento linguale è stata osservata in 3/9 pazienti all’EVG ed in 2/9 alla VFS. La deglutizione frammentaria è stata osservata solo all’EVG. Non è stato mai visualizzato il ristagno degli ingesti allo studio ecovideografico, presente in 2 pazienti alla VFS.
Conclusioni
L’ecovideografia può essere integrata nel protocollo diagnostico dello studio della deglutizione nei pazienti con SLA grazie alla maggiore sensibilità rispetto alla VFS nel valutare i reperti dinamici che rappresentano segni precoci di disfagia.
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Tamburrini, S., Solazzo, A., Sagnelli, A. et al. Amyotrophic lateral sclerosis: sonographic evaluation of dysphagia. Radiol med 115, 784–793 (2010). https://doi.org/10.1007/s11547-010-0523-2
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DOI: https://doi.org/10.1007/s11547-010-0523-2