A Case With Dermatomyositis-related Swallowing Disorder Treated by Intermittent Oro-Esophageal Tube Feeding

A seventy-year-old man was admitted to our hospital for treatment of dermatomyositis. The patient complained of progressive dysphagia symptom after admission and prednisolone therapy was administered. Videofluoroscopic examination of the patient swallowing showed poor laryngeal excursion, delayed swallow reflex, decreased pharyngeal peristalsis and impaired laryngeal closure. Thus, swallowing therapy, including muscle exercises around the neck and the tongue, were started immediately. In addition, intermittent oroesophageal tubing technique (IOE) was introduced for improved swallowing function, since IOE is easily performed in patients without gag reflex induced by pharyngeal stimulation. The patient mastered the selftubing technique within a few days and continued IOE. The patient's swallowing function gradually improved and he could intake food at 13 weeks after the introduction of IOE therapy. IOE is effective to improve nutrition status and swallowing function for patients with swallowing dysfunction caused by the abnormalities of pharyngeal stage in deglutition.