title: [Videofluorographic assessment of swallowing function in patients with Duchenne muscular dystrophy].
abstract: OBJECTIVE
  To identify the characteristics of swallowing function in patients with Duchenne muscular dystrophy (DMD).
  
  
  METHODS
  Swallowing function was evaluated using videofluorography (VF) in a cross-sectional observational study of 102 DMD patients (mean age 21.5 years) who had dysphagia or in whom dysphagia was suspected based on clinical signs. Reduced tongue movement, impaired bolus transport to the pharynx, decreased pharyngeal contraction, bolus delivery into the airway, and bolus residue at the epiglottic vallecula and at the piriform recess were qualitatively evaluated for test swallows of jelly and juice. During VF, the length of time of both the oral and pharyngeal phases of swallowing was measured in 59 patients.
  
  
  RESULTS
  Patients started to show oral phase abnormalities in their mid-teens and pharyngeal phase abnormalities such as pharyngeal residue around age 20. Oral phase abnormalities was higher with juice than with jelly. Total oral/pharyngeal transit duration was longer with age, and total duration of hyoid maximum elevation was shorter with age.
  
  
  CONCLUSIONS
  The weak positive correlation of total oral/pharyngeal transit duration and age was presumably due to gradual onset of functional abnormalities associated with deteriorated swallowing muscles starting in the teenage years. Reduced tongue movement and impaired bolus transport to the pharynx was more common in teenage DMD patients because they have limited tongue movements associated with structural abnormalities such as macroglossia and open bite. VF showed that the swallowing difficulties were more severe during the oral phase than in the pharyngeal phase in the teenage patients. The pharyngeal phase disorders such as pharyngeal residue and decreased pharyngeal contraction were seen more often in the patients in their 20s, presumably due to deterioration of swallowing muscles that becomes more apparent in the older age group.
authors: Clinical Research Division, Department of Neurology, Tokushima National Hospital, National Hospital Organization, 1354 Shikiji, Kamojima, Yoshinogawa, Tokushima 776-8585 Japan.
authors: Sonoko
authors: S
authors: Nozaki
authors: Yoshifumi
authors: Y
authors: Umaki
authors: Shuhei
authors: S
authors: Sugishita
authors: Katsunori
authors: K
authors: Tatara
authors: Katsuhito
authors: K
authors: Adachi
authors: Susumu
authors: S
authors: Shinno
mesh_terms: D000293:Adolescent; D000328:Adult; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005471:Fluoroscopy; D006801:Humans; D020388:Muscular Dystrophy, Duchenne / Q000503:physiopathology*; D014743:Videotape Recording