2019 Volume 47 Issue 2 Pages 65-71
Objective: Changes to swallowing function over time were investigated in patients with cortical cerebellar atrophy (CCA).
Subjects and Methods: Forty-five CCA patients who underwent videofluorographic swallowing examinations (VF) at our hospital between June 2008 and March 2013 were divided into two groups (early group, ≤10 years; late group, ≥10 years) based on the time from appearance of the initial symptom. Years elapsed, total score on the International Cooperative Ataxia Rating Scale, diet consistency at the time of examination, and history of aspiration pneumonia were retrospectively examined in both groups based on medical records. Additionally, the presence of aspiration/laryngeal entry, oral transit time, pharyngeal transit time, pharyngeal delay time, and residual cooked rice in the oral cavity/epiglottic vallecula/pyriform sinus were examined with VF (10ml fluid and cooked rice). The t-test, Mann-Whitney U test, and Fisher’s exact test were used for statistical analysis.
Results: The early group comprised of 25 patients (elapsed time, 7.2 years; normal meal, n=25), and the late group comprised of 20 patients (elapsed time, 15.3 years; normal meal, n=16; rice porridge, n=4). No patient had a history of aspiration pneumonia. The duration of each swallowing phase on VF was extended with the consumption of cooked rice in the late group. The percentage of patients with residual food in the epiglottic vallecula and pyriform sinus was significantly greater in the late group than that in the early group.
Discussion: Many patients with CCA continue to eat normal meals even 10 years CCA onset. However, significant pharyngeal residue and extension of the swallowing phases were observed. These findings indicate that, it is necessary to be aware of the decline in swallowing function while maintaining the quality of the diet.
