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01-03-2021 | Dysphagia | Original Communication

Cricopharyngeal bar on videofluoroscopy: high specificity for inclusion body myositis

Authors: Kenichiro Taira, Toshiyuki Yamamoto, Madoka Mori-Yoshimura, Kazuaki Sajima, Hotake Takizawa, Jun Shinmi, Yasushi Oya, Ichizo Nishino, Yuji Takahashi

Published in: Journal of Neurology | Issue 3/2021

Abstract

Objective

To determine the prevalence and characteristics of the cricopharyngeal bar (CPB), defined as marked protrusion with lacking relaxation and stricture of the upper esophageal sphincter on videofluoroscopy, in patients with inclusion body myositis (IBM).

Methods

We conducted a case–control study of comprehensive series of adult healthy individuals and consecutive patients with neuropsychiatric disorders aged over 45 (52 versus 2486). A standard videofluoroscopy was performed.

Results

Overall, 47 individuals with CPB were identified. Of the individuals with CPB, 36% were IBM followed by neurodegenerative disorders, muscular disorders, neuromuscular disorders, and others (32%, 21%, 2.1%, and 8.5%, respectively), indicating the heterogeneity of the etiologies. Against muscular disorders, the sensitivity and specificity of the CPB for IBM were 33% (= 17/52; 95% confidence interval [CI], 20–45%) and 96% (= 264/274; 95% CI, 94–99%), respectively. IBM with CPB showed a higher frequency of obstruction-related dysphagia (88% versus 22%, p < 0.001) and severe CPB (76% versus 23%, p < 0.001) than the control with one. The ratio of the upper esophageal distance at the maximum distension at the level of C6 to that of C4 was lower in IBM with CPB than in the controls with one (0.50 versus 0.77, p < 0.001), which suggests the insufficient opening of the upper esophageal sphincter.

Conclusion

A CPB could be indicative of IBM. The upper esophagus in IBM with CPB became narrow, like a bottleneck. We provide new perspectives of dysphagia diagnosis by videofluoroscopy, especially for IBM-associated dysphagia, to expand the knowledge on the CPB.

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Title: Cricopharyngeal bar on videofluoroscopy: high specificity for inclusion body myositis
Authors: Kenichiro Taira
Toshiyuki Yamamoto
Madoka Mori-Yoshimura
Kazuaki Sajima
Hotake Takizawa
Jun Shinmi
Yasushi Oya
Ichizo Nishino
Yuji Takahashi
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keywords: Dysphagia
Dysphagia
Dysphagia
Published in: Journal of Neurology / Issue 3/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10241-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cricopharyngeal bar on videofluoroscopy: high specificity for inclusion body myositis

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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