Houser S M, Calabrese L H, Strome M
Department of Otolaryngology and Communicative Disorders, Cleveland Clinic Foundation, Ohio 44195, USA.
Laryngoscope. 1998 Jul;108(7):1001-5. doi: 10.1097/00005537-199807000-00009.
Inclusion body myositis (IBM) is an inflammatory myopathy with a 40% reported incidence of dysphagia. A protracted course, refractory to medical therapy, frequently leads to consultation with an otolaryngologist for dysphagia management. We studied the incidence, symptoms, and mechanisms of dysphagia in patients with IBM.
Retrospective study of medical records and self-reported follow-up survey; dysphagia is defined as difficulty in swallowing.
Twenty-two patients with biopsy-proven IBM.
The rate of dysphagia was more than 80% (16 of 19), twice as high as previously reported. Progressive dysphagia was associated with a significantly worse functional class. Relevant management guidelines are established, including the timing for appropriate surgical intervention.
Progressive dysphagia may signify more aggressive IBM or an episodic worsening in status. Recognition of the disease manifestations will afford proper patient management. Informed otolaryngologists can have a favorable impact on the dysphagia associated with IBM.
包涵体肌炎（IBM）是一种炎性肌病，据报道吞咽困难的发生率为40%。病程迁延，药物治疗无效，常导致患者因吞咽困难而咨询耳鼻喉科医生以进行治疗。我们研究了IBM患者吞咽困难的发生率、症状及机制。
对病历和自我报告的随访调查进行回顾性研究；吞咽困难定义为吞咽困难。
22例经活检证实为IBM的患者。
吞咽困难发生率超过80%（19例中的16例），是先前报道的两倍。进行性吞咽困难与功能分级明显较差有关。建立了相关管理指南，包括适当手术干预的时机。
进行性吞咽困难可能意味着IBM病情更严重或病情间歇性恶化。认识疾病表现将有助于对患者进行适当管理。知识渊博的耳鼻喉科医生可对与IBM相关的吞咽困难产生积极影响。
