Bruno FattoriPisa University Hospital, Italy
Title: Dysphagia in Parkinson's disease: Pharyngeal manometry and fiberoptic endoscopic evaluation
Dysphagia is a common symptom in Parkinson’s disease (PD), and it contributes to a poorer prognosis because of its complications. In this study 20 patients affected by PD and 20 healthy controls were evaluated by Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Pharyngeal High-Resolution Manometry (PHRM). The study showed that Pmax (the maximum pressure elicited by the single pharyngeal muscle structures involved in swallowing) was significantly lower in PD compared to controls (p<0.05) for all the boluses’ volumes and textures tested, especially at the level of the tongue base and the cricopharyngeal muscle. Pmean (pre-swallowing pressure), which represents the mean value of a contraction in which basal and maximal pressure were normally calculated, was significantly higher in PD compared to normal subjects, again at the level of the tongue base and the cricopharyngeal muscle (p<0.05). Mean intra-swallowing pressure was higher for the velopharynx and the cricopharyngeal muscle, but lower for the tongue base. Pmax and Pmean at PHRM were altered independently from the degree of dysphagia detected at FEES, and they did not correlate either with the location of the residue or with the type of bolus. In conclusion, PHRM is particularly useful in the early detection of dysphagia, when FEES may still not be able to detect evidence of abnormal swallowing.
Bruno Fattori works as an Associate Professor in Otorhinolaryngology at Pisa University Hospital (Pisa, Italy). He served as President of the Italian Study Group on Dysphagia (GISD) (2014-2015), and the Italian Society of Phoniatrics and Speech Language Pathology (SIFEL) (2017-2019). He has published more than 200 scientific publications on the major international and national journals in the field of clinical and instrumental phoniatric diagnostics, otoneurological diagnostics and swallowing disorders. He is a Referee for the Italian Ministry of Education, University and Research (MIUR) for the “S.I.R.” program (Scientific Independence of Young Researchers). He collaborates as referee and reviewer with some of the most important journals in the field of otorhinolaryngology