Electrophysiological evaluation of swallowing function in patients with sjögren's syndrome and systemic sclerosis

Objective: Sjögren's syndrome is an autoimmune disease characterized by dry eyes and mouth as a result of lymphocytic infiltration in the salivary and lacrimal glands. Neurological complications develop in approximately half of the patients. Dysphagia is seen in three-quarters of patients with Sjögren's syndrome. This complication is attributed to decreased salivation and esophageal dysmotility. Systemic sclerosis is an autoimmune disease characterized by thickening and hardening of the skin and connective tissue. While only skin involvement develops in some patients, blood vessels, internal organs and digestive system involvement are also observed in some patients. Esophageal hypomotility is one of the important and diagnostic clinical findings in scleroderma. Manometry studies to reveal the etiology of esophageal dysphagia and videofluoroscopy examinations used to evaluate oropharyngeal dysphagia are among the methods. Detection of subclinical oropharyngeal dysphagia with electrophysiological methods that do not have side effects and give objective results, instead of these examinations, may be beneficial for the treatment measures to be taken. In Sjögren's syndrome and Systemic sclerosis, the number of studies evaluating oropharyngeal swallowing electrophysiologically is limited and examined with different techniques. Methods: Sixteen patients with Sjögren's syndrome and 21 patients with systemic sclerosis who were followed up in Tekirdağ Namık Kemal University, Department of Internal Medicine, Department of Rheumatology were included. The age, gender, duration of the disease, and concomitant diseases of the patients were evaluated. The normal control group was determined by considering the exclusion criteria with 20 patients. Dysphagia clinical examination was performed for all patients In the dysphagia rating (DD), Ertekin et al. scale was used. Electrophysiologically ill and all healthy volunteers underwent electrophysiological (EF) evaluation for swallowing. In this evaluation, 3 separate studies were applied: 1. Single Swallow Analysis, 2. Dysphagia Limit, 3. Drinking Water from a Glass Test. Results: While the dysphagia limit was >20 ml in the whole of the normal control group, the dysphagia limit was found to be lower than 20 ml in 13 (61.9%) of 21 patients with scleroderma. In patients with Sjögren's diagnosis, the dysphagia limit was lower than the control value in 13 (81.3%) of 16 patients. found. Sequential swallowing was evaluated with the 100 ml glass drinking test, and the number of swallows was found to be increased in 8 (50%) patients with scleroderma and 9 (42.9%) patients with sjogren's disease compared to the control group. Conclusion: In our study, patients whose oropharyngeal dysphagia were evaluated were evaluated for dysphagia by electrophysiological methods. In the sequential water swallow test and dysphagia limit test, high rates of pathologies were detected in both patient groups, and it was observed that the use of these tests could be useful in the diagnosis and follow-up of dysphagia.