Videofluoroscopic Evaluation of Swallowing in Patients with Amyotrophic Lateral Sclerosis / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Dysphagia in patient with amyotrophic lateral sclerosis (ALS) is a critical symptom for prognosis. Proper evaluation and follow-up of their dysphagia is also important in management. Videofluoroscope is the gold standard method for evaluation of swallowing in ALS patients. The object of this study is to evaluate their dysphagia using videofluoroscope, on the basis of which we can plan the optimal rehabilitation method. SUBJECTS AND METHOD: The clinical records and videofluoroscopes of 7 ALS patients were reviewed. All patients were classified according to Hillel's ALS swallowing score. We analysed their videofluoroscopes and implied proper treatment strategies on the basis of those findings. RESULTS: All patients had dysfunction of tongue. In the early stage, dysphagia was solely attributable to oral phase dysfunction. In the advanced stage, pharyngeal phase was also affected. In some patients, cricopharyngeal dysphagia and aspiration were observed. After various form of treatment such as tongue exercise, position change, swallowing maneuver, tube feeding, and botulinum toxin injection to cricopharyngeal muscle, we could observe improvement in swallowing function. CONCLUSION: Videofluoroscope is a good method for evaluating patients with ALS. By applying tailored treatment strategies on the basis of videofluoroscopic finding, we can properly manage patients with ALS and eventually improve their quality of life.