Chest
Cricopharyngeal Dysfunction in Chronic Obstructive Pulmonary Disease
Section snippets
Protocol
Based on our experience with three patients with severe COPD and clinically overt swallowing difficulties in whom cricopharyngeal dysfunction was verified, we studied an additional 22 patients with severe COPD who were subject to frequent exacerbations. All studies were performed in a community hospital. These studies were neither consecutive nor randomized, but were based upon historical data and the patient's willingness to have pharyngoesophageal studies with videotaping. Clinical historical
CASE REPORTS
A brief description of our index cases may IK* of help in describing this complication or abnormality.
RESULTS
We studied 25 patients with cricopharyngeal dysfunction who had moderate to severe COPD and FEV1 less than 70 percent of predicted (Table 1). All of these patients had been referred for frequent exacerbations of respiratory distress.
Twenty-one of the patients had dysfunction of the cricopharyngeous muscle shown by videotape recordings of the swallowing sequence. All patients studied except one were over the age of 50 years. There was an apparent association between age and severity of
DISCUSSION
Patients with COPD are commonly subject to frequent exacerbations which are assumed to be related to infection or bronchial hyperreactivity. Herein we have identified an additional factor, cricopharyngeal achalasia, in 21 of 25 patients. In 17 of these patients, it was judged to be severe, and in retrospect, all were found to have some degree of symptomatic dysphagia. Surgical correction in ten of them was associated with definite clinical improvement of pulmonary symptoms in eight.
Aspiration
REFERENCES (32)
- et al.
Aspiration pneumonia, anaerobic infections, and lung abscess
Med Clin North Am
(1980) - et al.
Measurement of gastroesophageal reflux
Castroenterology
(1969) - et al.
Pulmonary fibrosis associated with tracheobronchial aspiration
Chest
(1976) The pharyngoesophageal closure mechanisms: a manometric study
Gastroenterology
(1972)Functional disorders of the pharyngoesophageal junction: achalasia and chalasia
Radiol Clin North Am
(1969)An overview of obstructive lung diseases
Med Clin North Am
(1981)- et al.
Effect of theophylline on gastroesophageal reflux in normal adults
J Allergy Clin Immunol
(1981) Upper esophageal sphincter: does it care about reflux?
Gastroenterology
(1983)- et al.
Anatomy of the pharynx, pertinent to swallowing
Dysphagia
(1986) - et al.
Anaerobic infections of the lung and pleural space
Am Rev Respir Dis
(1974)
The pharyngo-esophageal sphincter: a review of the literature
Dan Med Bull
Disorders of the cricopharyngeous muscle: a review
Castroenterology
Dysfunction of the cricopharyngeal muscle
Radiology
Examination of the patient with dysphagia
Radiology
Ambulatory monitoring of oesophageal pH in reflux oesophagitis using a portable radiotelemetry system
Cut
Cricopharyngeous myotomy as the only treatment for Zenker diverticulum
Ann Otol
Cited by (55)
Pathophysiology of cachexia and characteristics of dysphagia in chronic diseases
2022, Asia-Pacific Journal of Oncology NursingDysphagia of cachexia and sarcopenia
2021, Sarcopenia: Molecular Mechanism and Treatment StrategiesRespiratory Disorders
2020, Dysphagia: Clinical Management in Adults and ChildrenSwallowing function and chronic respiratory diseases: Systematic review
2016, Respiratory MedicineCitation Excerpt :All four criteria stipulate that the diagnosis of COPD needs be confirmed by spirometry (post bronchodilator) with a ratio of Forced Expiratory Volume in one second (FEV1) and Forced Vital Capacity (FVC) below 70% (FEV1/FVC). Five studies [19,32,36,39,44] reported on the severity of COPD. In four of these studies, severe COPD was defined by FEV1 < 50% [32,36,39,44].
Respiratory and Iatrogenic Disorders
2016, Dysphagia: Clinical Management in Adults and ChildrenOropharyngeal dysphagia in exacerbations of chronic obstructive pulmonary disease
2011, European Geriatric Medicine