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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentations 1 - Laryngology/Broncho-Esophagology

Comparison of Esophageal Dysmotility Diagnostic Studies in Head and Neck Cancer Survivors With Dysphagia

Saturday, September 28, 2024
10:00 AM – 10:06 AM EDT
Location: MBCC, 224
Disclosure(s):
Akhil Katragadda, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Molly O. Meeker, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Mohammad Bilal Alsavaf, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jack L. Birkenbeuel, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Zachary A. Wykoff, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: This study aims to characterize the relationship of esophageal dysmotility on modified barium swallow (MBS) and esophagram studies with manometry, the gold standard of esophageal dysmotility diagnosis, in head and neck cancer (HNC) survivors with dysphagia.

Methods: A retrospective analysis of 30 patients treated for dysphagia between 2020-2023 was conducted. Inclusion criteria required HNC survivors aged 18 years or older who were diagnosed with dysphagia, treated in a HNC dysphagia clinic, and completed at least one manometry study. Data was collected on patient demographics, cancer history, MBS, esophagram, and manometry studies. MBS and esophagram results were reviewed for evidence of esophageal dysmotility. Manometry studies were assessed with Chicago Classification Version 4.0. Data was summarized using frequencies for categorical variables and sensitivities and specificities were calculated.

Results: Of the 30 patients reviewed, 18 (60%) showed esophageal dysmotility on manometry, 15 (50.0%) completed MBS only, 1 (3.3%) completed esophagram only, and 14 (46.7%) completed both MBS and esophagram. Patients with dysmotility presented with ineffective motility (n=6, 33.3%), EGJ outflow obstruction (n=5, 27.8%), absent contractility (n=3, 16.7%), hypercontractile esophagus (n=3, 16.7%), achalasia type 1 (n=1, 5.6%), and achalasia type 2 (n=1, 5.6%). Compared to the gold standard diagnosis of esophageal dysmotility on manometry, MBS sensitivity was 64.7% and specificity was 50.0%. Esophagram sensitivity was 75.0% and specificity was 0.0%. Two positive tests parallel MBS and esophagram sensitivity was 52.9% and specificity was 33.3%.

Conclusions: Esophageal dysmotility is an understudied comorbidity of dysphagia in the HNC survivor population. Our study suggests that MBS and esophagram have limited predictive value in the assessment of esophageal dysmotility in HNC survivors with dysphagia. Thus, future studies should aim to better understand the relationship between other aspects of post-HNC dysphagia and esophageal dysmotility.

    Presenting Author(s)

  • Akhil Katragadda, BS

    Medical Student
    The Ohio State University College of Medicine
    Columbus, Ohio, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Molly O. Meeker, BS

    Medical Student
    The Ohio State University College of Medicine
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • MA

    Mohammad Bilal Alsavaf, MD

    Research Fellow
    Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • JB

    Jack L. Birkenbeuel, MD

    PGY-3
    The Ohio State University Wexner Medical Center
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Zachary A. Wykoff, BS

    MS4
    The Ohio State University College of Medicine
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • SZ

    Songzhu Zhao

    Disclosure information not submitted.

    • Senior Author(s)

  • Apoorva T. Ramaswamy, MD

    Assistant Professor
    Ohio State University Hospital Program
    Columbus, OH, United States

    Disclosure information not submitted.