A Case of Impaired Upper Esophageal Sphincter Opening Due to Sarcopenic Dysphagia Successfully Treated With Balloon Dilatation

一例因肌少症性吞咽困难导致上食管括约肌开放障碍,经球囊扩张术成功治疗的病例报告

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Abstract

A case of an 84-year-old man diagnosed with "probable sarcopenic dysphagia" using the sarcopenic dysphagia diagnostic algorithm is presented. The patient demonstrated improved upper esophageal sphincter (UES) passage by the immediate effect of balloon dilatation. He had suffered a myocardial infarction and was unable to eat orally for approximately a month, presenting with sarcopenia and severe dysphagia, as indicated by the Food Intake LEVEL Scale (FILS) score of 1. Videofluoroscopic examination of swallowing study at 67 hospital days revealed impaired UES opening, with food bolus unable to pass through the UES. After confirming the loss of the gag reflex, we performed balloon dilatation, resulting in improved UES passage. With swallowing rehabilitation using balloon dilatation and appropriate nutritional therapy, the patient progressed to full oral intake and achieved FILS score of 8. This case suggests the effectiveness of combined nutritional therapy and swallowing rehabilitation with balloon dilatation in managing sarcopenic dysphagia. In addition, balloon dilatation could be applied for patients with sarcopenic dysphagia presenting impaired UES opening.

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