Original Report

Esophageal Dysmotility is Common in Patients With Multiple System Atrophy

Corresponding Author

Rumi Ueha MD, PhD

[email protected]

orcid.org/0000-0002-0608-7237

Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

Send correspondence to Rumi Ueha, Department of Otolaryngology, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan. E-mail: [email protected]Search for more papers by this author

Taku Sato MD,

Taku Sato MD

orcid.org/0000-0002-5871-1425

Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

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Takao Goto MD,

Takao Goto MD

Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

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Akihito Yamauchi MD, PhD,

Akihito Yamauchi MD, PhD

Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

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Nogah Nativ-Zeltzer SLP, PhD,

Nogah Nativ-Zeltzer SLP, PhD

orcid.org/0000-0003-1511-5321

Department of Otolaryngology, The University of California, Davis, California, U.S.A.

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Jun Mitsui MD, PhD,

Jun Mitsui MD, PhD

Department of Neurology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

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Peter C. Belafsky MD, PhD,

Peter C. Belafsky MD, PhD

orcid.org/0000-0003-0288-2839

Department of Otolaryngology, The University of California, Davis, California, U.S.A.

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Tatsuya Yamasoba MD, PhD,

Tatsuya Yamasoba MD, PhD

Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

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Rumi Ueha MD, PhD,

Corresponding Author

Rumi Ueha MD, PhD

[email protected]

orcid.org/0000-0002-0608-7237

Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

Send correspondence to Rumi Ueha, Department of Otolaryngology, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan. E-mail: [email protected]Search for more papers by this author

Taku Sato MD,

Taku Sato MD

orcid.org/0000-0002-5871-1425

Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

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Takao Goto MD,

Takao Goto MD

Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

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Akihito Yamauchi MD, PhD,

Akihito Yamauchi MD, PhD

Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

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Nogah Nativ-Zeltzer SLP, PhD,

Nogah Nativ-Zeltzer SLP, PhD

orcid.org/0000-0003-1511-5321

Department of Otolaryngology, The University of California, Davis, California, U.S.A.

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Jun Mitsui MD, PhD,

Jun Mitsui MD, PhD

Department of Neurology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

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Peter C. Belafsky MD, PhD,

Peter C. Belafsky MD, PhD

orcid.org/0000-0003-0288-2839

Department of Otolaryngology, The University of California, Davis, California, U.S.A.

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Tatsuya Yamasoba MD, PhD,

Tatsuya Yamasoba MD, PhD

Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

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First published: 04 July 2020

https://doi.org/10.1002/lary.28852

Citations: 4

This work was supported by JSPS KAKENHI Grant-in-Aid for Scientific Research (C) [grant number 16 K20231].

Editor's Note: This Manuscript was accepted for publication on May 22, 2020.

The authors have no conflicts of interest to declare.

This manuscript was scheduled for a poster presentation at the Combined Otolaryngology Spring Meetings 2020, April 22–26, Atlanta, Georgia, U.S.A.

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Abstract

Objectives

Esophageal dysmotility (ED) in patients with multiple system atrophy (MSA) are poorly understood. This study aimed to investigate the prevalence of ED in patients with MSA and to assess the relationship of esophageal abnormalities with other clinical findings and characteristics in these patients.

Methods

A retrospective chart review was conducted to identify patients with MSA and to compare them to the elderly controls without MSA (65+ years) who underwent a videofluorographic esophagram from 2014 to 2019. Disease type, disease severity, vocal fold mobility impairment, abnormal deglutitive proximal esophageal contraction (ADPEC), and intra-esophageal stasis (IES) were reviewed and compared between groups.

Results

Thirty-seven patients with MSA were identified. The median age was 63 and 26 (70%) were male. These patients were matched to 22 elderly adults with presbylarynx but not MSA (median age 77, 68% male). In MSA patients, cerebellar variant type was predominant (59%), and ADPEC was recognized in 18 patients (49%). Disease severity level (P = 0.028) and existence of IES (P = 0.046) were associated with higher risks of developing ADPEC. The prevalence of IES was significantly higher in patients with MSA (95%) compared to controls without MSA (46%) (P < 0.001). Disease severity level and the existence of IES were significantly associated with the presence of ADPEC (p < 0.05).

Conclusion

ADPEC and IES were significantly more common in MSA than in elderly subjects without MSA. MSA severity is associated with the development of ADPEC. The data suggest that esophageal motility is predominantly affected in MSA.

Level of Evidence

3 Laryngoscope, 131:832–838, 2021

Supporting Information

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Citing Literature

Volume131, Issue4

April 2021

Pages 832-838

Esophageal Dysmotility is Common in Patients With Multiple System Atrophy

Abstract

Objectives

Methods

Results

Conclusion

Level of Evidence

Supporting Information

BIBLOGRAPHY

Citing Literature

References

Information

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Esophageal Dysmotility is Common in Patients With Multiple System Atrophy

Abstract

Objectives

Methods

Results

Conclusion

Level of Evidence

Supporting Information

BIBLOGRAPHY

Citing Literature

References

Related

Information