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THU0239 Oropharyngeal dysfunction in systemic sclerosis
  1. F Cozzi1,
  2. F Pomerri2,
  3. N Durigon1,
  4. A Bullo1,
  5. L Semerano1,
  6. P Sfriso1,
  7. S Todesco1
  1. 1Division of Rheumatology
  2. 2Institute of Radiology, Padova University, Padova, Italy

Abstract

Background Esophagopathy is one of the most frequent visceral organ involvements in Systemic Sclerosis (SSc). Fibrous tissue substitution of the visceral wall progressively compromises peristalsis and leads to lower oesophageal sphincter incompetence, with dysphagia and reflux esophagitis. The process most frequently involves the lower two thirds of the oesophagus, but in many patients, oropharynx and the upper third of the oesophagus can be involved as well.

Objectives In order to evaluate this aspect of the disease, we submitted a group of sclerodermic patients to videofluorography with contrast agent, a technique that allows to study the oropharyngeal phase of deglutition.

Methods We evaluated 36 SSc patients, 33 female, 3 male, mean age 52 yrs. (range 27–75), mean disease duration 8.5 yrs., 23 with limited SSc, 13 with diffuse SSc. They underwent videofluorography with barium sulphate, which allows to study either the oropharyngeal or the oesophageal phase of deglutition.

Results In 31 patients (86.1%) we detected radiographic abnormalities, in 11 (30.6%) of both phases, in 16 (44.4%) of the esophageal phase only, in 4 (11.1%) of the oropharingeal phase only. The oropharyngeal abnormalities, detected in 15(41.7%) patients, comprised: incompetence of palatoglossus histmus and palatopharyngeus histmus, stasis of the contrast agent in the valleculae and pyriform recesses, and its penetration inside laryngeal haditus.

Conclusion Our study demonstrates that in many SSc patients, even the first phase of deglutition, the oropharyngeal one, is altered. Tissue fibrosis involves even oropharyngeal structures, compromising deglutition in the first phase with higher risk of ab ingestis phenomena.

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