title: [Changes of swallowing function and their significance in Chiari I malformation patients with dysphagia after decompression surgery].
abstract: OBJECTIVE
  To survey changes of swallowing function and their significance in Chiari I malformation   patients with dysphagia after Atlanto-occipital Decompression with Duraplasty by comparing water swallowing test  results and other clinical features before and after surgery.
  
  
  METHODS
  From January 2007 to July 2010, 126 Chiari I malformation patients were treated in Neurosurgery Department of Peking University Third Hospital. Clinical  data were prospectively analyzed. There were 34 cases (26.9%, 34/126) with varying severity of dysphagia. All of  those patients underwent Atlanto-occipital Decompression with Duraplasty. Water swallowing tests were performed  1 day before operation and after 7-10 days to assess dysphagia severity. The improvements of other major symptoms  and signs after surgery were also compared.
  
  
  RESULTS
  Postoperative dysphagia was improved in 23 cases (67.6%,  23/34), and drinking water test score of preoperation was (2.74±1.11). The score was significantly reduced to  (1.71±0.91) after the operation (P<0.05). Other major symptoms and signs were analyzed by Fisher's exact test  which showed that only neck and shoulder pain (P=0.01) improved significantly, compared with preoperation.
  
  
  CONCLUSIONS
  Indeed part of the Chiari I malformation patients suffer from varying severity of dysphagia. The  detailed clinical history collection and physical examination may improve the initial detection rate of  dysphagia. Water swallow test is useful to quantify the degree of dysphagia. Atlanto-occipital Decompression  with Duraplasty can improve treatment of Chiari I malformation patients with dysphagia. Improvement in treating  dysphagia shortly after operation may be an effective index to evaluate the effect of surgery.
authors.affiliation: Department of Neurosurgery, Peking University Third Hospital, Beijing 100191, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Yu
authors.forename: Zhen-yu
authors.initials: ZY
authors.lastname: Wang
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Duan
authors.forename: Chang-cheng
authors.initials: CC
authors.lastname: Ma
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.forename: Jia
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D001269:Atlanto-Occipital Joint; D019299:Decompression, Surgical / Q000379:methods*; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology; D004388:Dura Mater / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis