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J Neurol Surg B Skull Base 2018; 79(06): 606-613
DOI: 10.1055/s-0038-1655758
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Swallowing Dysfunction in Adult Patients with Chiari I Malformation

Fawaz S. Almotairi   *
1   Department of Neurosurgery, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
,
Mats Andersson   *
2   Department of Radiology, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
,
Olof Andersson
3   Department of Otorhinolaryngology, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
,
Thomas Skoglund
1   Department of Neurosurgery, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
,
Magnus Tisell
1   Department of Neurosurgery, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
› Author Affiliations
Further Information

Publication History

12 January 2018

15 April 2018

Publication Date:
25 May 2018 (online)

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Abstract

Background Swallowing difficulties have been reported in patients with Chiari I malformation (CMI) with a prevalence of 4 to 47%, but existing evidence is based only on case reports. We aimed to prospectively study swallowing function in adult patients with CMI before and 3 months after surgical decompression.

Methods We included all adult patients diagnosed with CMI from September 2015 to October 2017 who underwent a planned surgery at Sahlgrenska University Hospital, Sweden. The patients were offered the opportunity to participate in and undergo an assessment consisting of the “Watson Dysphagia Scale (WDS)” and “EORTC QLQ-OG25” written questionnaires in addition to videofluoroscopic examination of swallowing (VFS) before and 3 months after surgery. Demographic data and comorbidities were recorded.

Results Eleven patients were included, nine of which underwent both pre- and postoperative evaluations. Four patients (36%) reported varying degrees of swallowing complaints (mean WDS score, 16). In two of these, there was substantial penetration of contrast material into the laryngeal vestibule on VFS, and in the other two patients, minor swallowing disturbances were observed. Borderline deviations from normal VFS findings were also found in three asymptomatic patients. Although not all VFS deviations completely disappeared after surgery, the patients reported no remaining symptoms.

Conclusion Symptoms of dysphagia and objective abnormalities on VFS are not uncommon in CMI patients. Surgery has the potential to remedy underlying causes of dysphagia, thereby relieving its symptoms.

Keywords

Arnold–Chiari Malformation - deglutition disorders - deglutition - surveys and questionnaires - decompressive craniectomy - treatment outcome - adult

* These authors contributed equally to the completion of this manuscript.


 

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