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Owing to rapid population aging, patients with dysphagia are significantly increasing in society. Dysphagia treatment is aimed at the restoration of the swallowing function and the prevention of recurrent aspiration-induced pulmonary infection. However, despite intensive rehabilitation, oral food intake remains inadequate in many patients with severe dysphagia, which results in the deterioration of patients’ quality of life and joy of living. Surgical intervention may serve as a useful therapeutic strategy to restore swallowing function in these patients. The study included 25 patients (mean, 70.4 years; male/female ratio, 20:5) with chronic dysphagia. Dysphagia was associated with cerebrovascular diseases in sixteen patients; with age-induced physiological deterioration in five patients; and with miscellaneous etiologies in four cases. Cricopharyngeal and infrahyoid myotomies were performed in all patients. Laryngeal elevation and the medialization of the paralyzed vocal fold were performed in 15 and 3 patients, respectively. The Food Intake Level Scale (FILS) and videoendoscopic examination score (VEES) were used to evaluate swallowing function. The FILS showed a restoration of oral food intake alone in 72% of patients, and 64% of patients maintained this improvement at their last follow-up visit. We observed significantly improved VEES scores postoperatively. However, patients with cognitive impairment or advanced age showed poor outcomes. In conclusion, surgical intervention may be an effective therapeutic option to restore swallowing function in cases of sustained severe dysphagia; however, surgical indications require careful consideration. Full article

(1) Background: Dysphagia is a clinical hallmark and part of the current American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) diagnostic criteria for idiopathic inflammatory myopathy (IIM). However, the data on dysphagia in IIM are heterogenous and partly conflicting. The aim of this study was to conduct a systematic review on epidemiology, pathophysiology, outcome and therapy and a meta-analysis on the prevalence of dysphagia in IIM. (2) Methods: Medline was systematically searched for all relevant articles. A random effect model was chosen to estimate the pooled prevalence of dysphagia in the overall cohort of patients with IIM and in different subgroups. (3) Results: 234 studies were included in the review and 116 (10,382 subjects) in the meta-analysis. Dysphagia can occur as initial or sole symptom. The overall pooled prevalence estimate in IIM was 36% and with 56% particularly high in inclusion body myositis. The prevalence estimate was significantly higher in patients with cancer-associated myositis and with NXP2 autoantibodies. Dysphagia is caused by inflammatory involvement of the swallowing muscles, which can lead to reduced pharyngeal contractility, cricopharyngeal dysfunction, reduced laryngeal elevation and hypomotility of the esophagus. Swallowing disorders not only impair the quality of life but can lead to serious complications such as aspiration pneumonia, thus increasing mortality. Beneficial treatment approaches reported include immunomodulatory therapy, the treatment of associated malignant diseases or interventional procedures targeting the cricopharyngeal muscle such as myotomy, dilatation or botulinum toxin injections. (4) Conclusion: Dysphagia should be included as a therapeutic target, especially in the outlined high-risk groups. Full article