Oropharingeal dysphagia in patients with chronic Chagas disease: phonoaudiological, videofluoroscopic, and manometric evaluations

Abstract

Objective: To determine the frequency of episodes of laryngeal penetration and aspiration in chronic Chagas patients and to evaluate the interpreted relationship not only with the patterns displayed in videofluoroscopy and manometry, but also with clinical screening and structural and functional phonoaudiological evaluation. Method: Clinical and phonoaudiological (structural and functional) evaluation, fluoroscopy, and computed manometry were performed on all patients. Results: Twenty-two patients were included in the study, fifteen females and seven males. Age ranged between 37 and 70 years, mean 55.9 ± 10.2 years. Among the complaints in clinical screening, 18.2% were choking, 13.6% reported throat-clearing, 40.9% heartburn, 22.7% regurgitation, and 36.4% had the sensation of food stuck in the throat. Only 18.2% of patients had adequate dentition. Functional assessment of swallowing detected only 31.8% capable of functional swallowing. In videofluoroscopy, lingering residues were found in the pharynx in 18.2% of cases, followed by multiple swallows 95.4% and 100% posterior escape. There were 4 cases of grade 2 laryngeal penetration (dysphagia) and, in 82% of cases, the findings were similar for the non-occurrence of laryngeal penetration in the videofluoroscopy and in the functional assessment of swallowing. The apertures of the upper esophageal sphincter indicated a relationship with the volume of swallowed bolus. In the manometry, 42.1% of changes were found in the body of the esophagus and 5.3% in the pharynx. Conclusion: Laryngeal penetration was prevalent in 18.2% of cases with an important interpretation of the functional relationship between clinical assessment and videofluoroscopic findings regarding the absence of laryngeal penetration, with similar results in 82% of cases.