Dysphagia in postpolio sequelae: report of three cases.

Findings on three postpolio sequelae patients referred for swallowing evaluations are presented. The first patient, a 67-year-old man more than 60 years post onset of polio, complained of frequent coughing and the sensation of foods becoming stuck in his throat during meals. Videofluoroscopic swallowing exam revealed reduced pharyngeal peristalsis and liquid pooling in the pyriform sinus. The second patient, a 59-year-old woman, was more than 30 years post onset of polio and was referred because of progressive dysphagia and hoarseness in the past three years. Videofluoroscopy revealed reduced strength of the oral musculature and reduced pharyngeal peristalsis with pooling of liquids in the pyriform sinus. The last patient, a 50-year-old woman more than 40 years post onset of polio, reported having difficulty with foods sticking in her throat. Swallowing exam revealed a delayed swallowing reflex and reduced pharyngeal peristalsis. Although none of the patients was observed to aspirate, all were considered to be at risk because of the gradual build-up of foods in the pharynx. Noninvasive management procedures and the importance of stress testing the swallowing mechanisms of such patients are discussed. Longitudinal follow-up with these individuals is recommended.