Abstract
Polymyositis and dermatomyositis are characterized by non-specific inflammation of the systemic skeletal muscles. Involvement of the pharyngolaryngeal muscles causes swallowing and articulatory disorders. In this report, the clinical aspects of 8 patients with polymyositis or dermatomyositis who complained of dysphagia were analyzed. The patients mean age was 66.6 years and the duration of their dysphagia ranged from 10 days to 7 years. Videofluorography showed impaired pharyngeal clearance and laryngeal elevation. In the majority of patients, cricopharyngeal obstruction was identified which resulted in aspiration. Manometric examination revealed weakened pharyngeal contraction and normal relaxation of the cricopharyngeal muscle. These findings suggested that the obstruction of the esophageal inlet was due to an impaired passive dilatation of the cricopharyngeal muscle. The clinical course of dysphagia did not correlate with the laboratory data or systemic muscle symptoms. In two patients, cricopharyngeal myotomy successfully treated sustained and severe dysphagia.
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