Clinical profile of cases of dysphagia presenting in ENT department: a study from rural tertiary care center
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20173039Keywords:
Dysphagia, Endoscopy, GERDAbstract
Background: Swallowing is a complex motor reflex requiring coordination among the neurologic system and muscles of the oropharynx and oesophagus. Disorders both benign and malignant may interfere with the process and cause dysphagia. We hereby undertake a study in a rural tertiary care centre to study the clinical profile of cases of dysphagia and to find the relative incidence of various etiologies of dysphagia.
Methods: A prospective study was conducted upon both out and indoor patients coming to Department of Otorhinolaryngology from January 2016 to January 2017 with predominant symptom of difficulty in swallowing for both solids, liquids or either. Detailed history & examination was done. Further endoscopy, barium swallow, fine needle aspiration cytology (FNAC) & biopsies were done as required. A total of 140 cases were taken into consideration.
Results: The mean age was 52.5 years with 60% patients males and 40% females. The commonest etiology of dysphagia was Gastroesophageal reflux disease (GERD) occupying 28.57%of cases. Among them 65% werefemales majority in the age group of 45-55 years. The 2nd common cause of dysphagia was growth pharynx 18.5% of cases. Among them 19 cases were diagnosed as growth oropharynx and 7 cases as growth supraglottis extending to hypopharynx. 88.46% were males and all were smokers. The 3rd common etiology of dysphagia was obstructive oesophageal causes which included oesophageal malignancies, oesophageal webs, strictures and diverticula in the frequency of 16%, 3%, 3% and 6% respectively. Oesophageal malignancies were mainly adenocarcinoma, all males who were chronic smokers.
Conclusions: Dysphagia is a commonly encountered clinical problem & limited studies exist regarding the prevalence of dysphagia etiologies. It is an alarm symptom, malignancy should be ruled out, and warrants early intervention.
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References
Gleeson M, Browning GG, Burton MJ, Clarke R, John H, Jones NS, et al. Scott-Brown’s otorhinolaryngology, head and neck surgery. 7th ed. London: Hodder Arnold; 2007.
Prades JM, Timoshenko AP, Asanau A, Gavid. M, Benakki H, Dubois MD, et al. The cricopharyngeal muscle and the laryngeal nerves: contribution to the functional anatomy of swallowing. Morphol. 2009;93(301):35–41.
Palmer JB, Matsuo K. Anatomy and physiology of feeding and swallowing: normal and abnormal. Phys Med Rehabil Clin N Am. 2008;19:691–707.
Lindgren S, Janzon L. Prevalence of swallowing complaints and clinical findings among 50–79-year-old men and women in an urban population. Dysphagia. 1991;6:187–92.
Groher ME. The prevalence of swallowing disorders in two teaching hospitals. Dysphagia 1986;1:3–6.
Paik NJ, Kim SJ, Lee HJ, Jeon JY, Lim JY, Han TR. Movement of the hyoid bone and the epiglottis during swallowing in patients with dysphagia from different etiologies. J Electromyography Kinesiol.2008;18(2):329-35.
Mackenzie SH, Go M, Chadwick B, Thomas K, Fang J, Kuwada S, et al. Eosinophilic oesophagitis in patients presenting with dysphagia--a prospective analysis. Aliment Pharmacol Ther. 2008;28:1140-46.
Veerappan GR, Perry JL, Duncan TJ. Prevalence of eosinophilic esophagitis in an adult population undergoingupper endoscopy: a prospective study. Clin Gastroenterol Hepatol. 2009;7:420-6.
Kidambri T, Toto E, Ho N, Taft T, Hirano I. Temporal trends in the relative prevalence of dysphagia etiologies from 1999-2009. World J Gastroenterol. 2012;18(32):4335-41.
American Gastroenterological Association. Medical position statement: evaluation of dyspepsia. Gastroenterol. 1998;114:579–81.
van Zyl JH, de K Grundling H, van Rensburg CJ, Retief FJ, O'Keefe SJ, Theron I, et al. Efficacy and tolerability of 20 mg pantoprazole versus 300 mg ranitidine in patients with mild reflux-oesophagitis: a randomized, double-blind, parallel, and multicentre study. Eur J Gastroenterol Hepatol. 2000;12:197-202.
Kalina Grivcheva-Stardelova1, Rozalinda Popova-Jovanova1, Gjorgji Deriban1, Nenad Joksimovic1 and MilkaZdravkovska. Dysphagia In Gastroesophageal Reflux Disease (Gerd). 2014;68(1):32-5.
Vakil N, Traxler B, Levine D. Dysphagia in patients with erosive esophagitis, prevalence, severity & response to proton pump inhibitors. Clinical Gastroenterol Hepatol. 2004;2:665–8.
DeVault KR, Castell DO. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol. 2005;100:195.
Duval M, Black MA, Gesser R, Krug M, Ayotte D. Multidisciplinary Evaluation and Management of Dysphagia: The Role for Otolaryngologists. J Otolaryngol Head Neck Surg. 2009;38(2):227-32.
Wynder EL, Hultberg S, Jacobsson F, Bross IJ. Environmental factors in cancer of the upper alimentary tract. A Swedish study with special reference to Plummer-Vinson (Paterson-Kelly) syndrome. Cancer. 1957;10:470-82.
Hoffmann RM, Jaffe PE. Plummer-Vinson syndrome. A case report andliterature review. Arch Intern Med. 1995;155:2008-111.
Seidler TO, Pèrez Alvarez JC, Wonneberger K, Hacki T. Dysphagia caused by ventral osteophytes of the cervical spine: clinical and radiographic findings. Eur Arch Otorhinolaryngol. 2009;266(2):285–91.
Calisaneller T, Ozdemir O, Tosun E, Altinors N. Dysphagia due to diffuse idiopathic skeletal hyperostosis. Acta Neurochir (Wien). 2005;147(11):1203-6.
Oppenlander ME, Orringer DA, La Marca F, McGillicuddy JE, Sullivan SE, Chandler WF, et al. Dysphagia due to anterior cervical hyperosteophytosis. Surgical Neurol. 2009;266–271.
Hawkins DB, Demeter MJ, Barnett TE. Caustic ingestion, controversies in management: a review of 214 cases. Laryngoscope. 1980;90:98-109.
Cello JPD, Ronald P, Fogel MD, Boland R. Liquid Caustic Ingestion Spectrum of Injury. Arch Intern Med. 1980;140(4):501-4.
Spiegel JR, Sataloff RT. Caustic injuries of the esophagus. Lippincott Williams Wilkins. 1999;34:557-64.
Chen PC. Esophago-gastric mucosal injury following vinegar ingestion. Chin J Gastroenterol. 1991;8:139-41.
Bergeron J, Long J, Chhetri DK. Dysphagia Characteristics in Zenker’s Diverticulum. Otolaryngol Head Neck Surg. 2013;148(2):223–8.
Malhotra A, Kottam RD, Spira RS. Dysphagia lusoria presenting with pill-induced Oesophagitis- A case report with review of literature. BJMP 2010;3(2):312..
Meher R, Agarwal S, Singh I. Tuberculous retropharyngeal abscess in an HIV patient. Hong Kong Med J. 2006;12:483-5.
Philpott CM, Selvadurai D, Banerjee AR. Paediatric retropharyngeal abscess. J Laryngol Otol. 2004;118:919-26.
Raza SN, Rahat ZM. Horner's syndrome as a co-presentation of tuberculous retropharyngeal abscess. J Coll Physicians Surg Pak. 2010;20:279-81.
Singh I, Chanda R, Gupta KB. Fatal pyothorax: a rare complication of retropharyngeal abscess. Indian J Chest Dis Allied Sci. 2003;45:265-8.
Tannebaum RD. Adult retropharyngeal abscess: a case report and review of the literature. J Emerg Med. 1996;14:147-58.
Kamath MP, Bhojwani KM, Kamath SU. Tuberculous retropharyngeal abscess. Ear Nose Throat J. 2007;86:236-7.
Steyer TE. Peritonsillar abscess: diagnosis and treatment.Am Fam Physician. 2002;65(1):93-6.
Khayr W, Taepke J. Management of peritonsillar abscess: needle aspiration versus incision and drainage versus tonsillectomy. Am J Ther. 2005;12(4):344-50.
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