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Swallowing Dysfunction in Adult Patients with Chiari I Malformation

Journal article
Authors Fawaz Almotairi
Mats Andersson
Olof Andersson
Thomas Skoglund
Magnus Tisell
Published in Journal of Neurological Surgery Part B-Skull Base
Volume 79
Issue 6
Pages 606-613
ISSN 2193-6331
Publication year 2018
Published at Institute of Neuroscience and Physiology
Institute of Clinical Sciences, Department of Otorhinolaryngology
Institute of Clinical Sciences, Department of Radiology
Pages 606-613
Language en
Links dx.doi.org/10.1055/s-0038-1655758
Keywords Arnold-Chiari Malformation, deglutition disorders, deglutition, surveys and questionnaires, penetration-aspiration scale, structural displacements, pharyngeal, constriction, eortc qlq-og25, dysphagia, population, cerebellum, deglutition, variability, validation, Neurosciences & Neurology, Surgery, llack if, 1992, neurosurgery, v30, p709
Subject categories Otorhinolaryngology

Abstract

Background Swallowing difficulties have been reported in patients with Chiari I malformation (CMI) with a prevalence of 4 to 47%, but existing evidence is based only on case reports. We aimed to prospectively study swallowing function in adult patients with CMI before and 3 months after surgical decompression. Methods We included all adult patients diagnosed with CMI from September 2015 to October 2017 who underwent a planned surgery at Sahlgrenska University Hospital, Sweden. The patients were offered the opportunity to participate in and undergo an assessment consisting of the "Watson Dysphagia Scale (WDS)" and "EORTC QLQ-OG25" written questionnaires in addition to videofluoroscopic examination of swallowing (VFS) before and 3 months after surgery. Demographic data and comorbidities were recorded. Results Eleven patients were included, nine of which underwent both pre- and postoperative evaluations. Four patients (36%) reported varying degrees of swallowing complaints (meanWDS score, 16). In two of these, there was substantial penetration of contrast material into the laryngeal vestibule on VFS, and in the other two patients, minor swallowing disturbances were observed. Borderline deviations from normal VFS findings were also found in three asymptomatic patients. Although not all VFS deviations completely disappeared after surgery, the patients reported no remaining symptoms. Conclusion Symptoms of dysphagia and objective abnormalities on VFS are not uncommon in CMI patients. Surgery has the potential to remedy underlying causes of dysphagia, thereby relieving its symptoms. OULEZZ AO, 1985, JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, V9, P1033

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