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KMID : 0361420150390061028
Journal of Korean Academy of Rehabilitation Medicine
2015 Volume.39 No. 6 p.1028 ~ p.1032
High Resolution Manometry Analysis of a Patient With Dysphagia After Occiput-C3/4 Posterior Fusion Operation
Oh Yoon-gul

Lee Seok-Tae
Ryu Ju-Seok
Abstract
Many reports of changes in cervical alignment after posterior occipitocervical (O-C) fusion causing dysphagia are available. The clinical course can range from mild discomfort to severe aspiration. However, the underlying pathogenesis is not well known. We report an 80-year-old female with videofluoroscopic swallowing study evidence of aspiration that developed after occiput-C3/4 posterior fusion. Pharyngeal pressure was analyzed using high resolution manometry (HRM). Impaired upper esophageal sphincter opening along with diminished peristalsis and pharyngeal pressure gradient were revealed by HRM to be the main characteristics in such patients. The patient fully recovered after a revision operation for cervical angle correction. Distinct pressure patterns behind reversible dysphagia caused by a change in cervical alignment were confirmed using HRM analysis.
KEYWORD
Manometry, Deglutition disorders, Cervical vertebrae, Neurosurgery
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