Resumo
O presente estudo teve como objetivo avaliar o impacto da terapia fonoaudiológica na disfagia orofaríngea em pacientes com esclerose sistêmica (ES) e dermatomiosite (DM), comparando terapia estruturada associada ao gerenciamento fonoaudiológico versus gerenciamento fonoaudiológico isolado. Conduziu-se um estudo piloto observacional com 19 participantes (7 DM e 12 ES), entre 18 e 65 anos, com disfagia orofaríngea. Os participantes foram alocados em dois grupos: grupo A (terapia fonoaudiológica estruturada + gerenciamento fonoaudiológico) e grupo B (gerenciamento fonoaudiológico isolado). Após oito meses, foram reavaliados com os mesmos parâmetros iniciais. Nos pacientes com ES, observou-se redução dos sintomas em ambos os grupos, com maior magnitude no grupo A. Nos pacientes com DM, houve melhora discreta, sem diferença relevante entre os grupos. A terapia fonoaudiológica esteve associada à melhora de parâmetros clínicos da disfagia, especialmente em pacientes com ES. Devido à amostra reduzida, os resultados devem ser interpretados como exploratórios.
Referências
McCarty EB, Chao TN. Dysphagia and swallowing disorders. Med Clin North Am. 2021;105(5):939-54. https://doi.org/10.1016/j.mcna.2021.05.013
Ahuja NK, Clarke JO. Scleroderma and the esophagus. Gastroenterol Clin North Am. 2021;50(4):905-18. https://doi.org/10.1016/j.gtc.2021.08.005
Cheng I, Wong C-M. A systematic review and meta-analysis on the prevalence and clinical characteristics of dysphagia in patients with dermatomyositis. Neurogastroenterol Motil. 2023;35(9):e14572. https://doi.org/10.1111/nmo.14572
Baker J, Barnett C, Cavalli L, Dietrich M, Dixon L, Duffy JR, et al. Management of functional communication, swallowing, cough and related disorders: consensus recommendations for speech and language therapy. J Neurol Neurosurg Psychiatry. 2021;92(10):1112-25. https://doi.org/10.1136/jnnp-2021-326767
Nudelmann LM, Marafon DP, Islabão AG, Staub HL. Doenças reumáticas. In: Jotz GP, Carrara-de Angelis E, Barros APB, editors. Tratado da deglutição e disfagia. Rio de Janeiro: Revinter; 2009. p. 101-18.
Cheng I, Wong CSM, Chan HHL. A retrospective review of clinical characteristics and risk factors of dysphagia in patients with dermatomyositis. Dysphagia. 2025;40(3):626-36. https://doi.org/10.1007/s00455-024-10763-6
Fitzgerald R, Triadafilopoulos G. Esophageal manifestation of rheumatic disorders. Semin Arthritis Rheum. 1997;26:641-66. In: Jotz GP, Carrara-de Angelis E, Barros APB, editors. Tratado da deglutição e disfagia. Rio de Janeiro: Revinter; 2009. p. 145-70.
Shaik MR, Shaik NA, Mikdashi J. Autoimmune dysphagia related to rheumatologic disorders: a focused review on diagnosis and treatment. Cureus. 2023;15(7):e41883. https://doi.org/10.7759/cureus.41883
Padovani AR, Moraes DP, Mangili LD, Andrade CRF. Protocolo fonoaudiológico de avaliação do risco para disfagia (PARD). Rev Soc Bras Fonoaudiol. 2007;12(3):199-205. https://doi.org/10.1590/S1516-80342007000300007
Hegland KW, Murry T. Nonsurgical treatment: swallowing rehabilitation. Otolaryngol Clin North Am. 2013;46(6):1073-85. https://doi.org/10.1016/j.otc.2013.08.003
Mendoza FA, DiMarino A, Cohen S, Adkins C, Abdelbaki S, Rattan S, et al. Treatment of severe swallowing dysfunction in systemic sclerosis with IVIG: role of antimuscarinic antibodies. J Clin Med. 2022;11(22):6665. https://doi.org/10.3390/jcm11226665
Netto PI, Carrara-de Angelis E, Barros B. Princípios da reabilitação das disfagias orofaríngeas. In: Jotz GP, Carrara-de-Angelis E, Barros APB, editors. Tratado da deglutição e disfagia: no adulto e na criança. Rio de Janeiro: Revinter; 2009. p. 330-41.
Motta F, Di Simone N, Selmi C. The impact of menopause on autoimmune and rheumatic diseases. Clin Rev Allergy Immunol. 2025;68(1):32. https://doi.org/10.1007/s12016-025-09031-8
Kadakuntla A, Juneja A, Sattler S, Agarwal A, Panse D, Zakhary N, et al. Dysphagia, reflux and related sequelae due to altered physiology in scleroderma. World J Gastroenterol. 2021;27(31):5201-18. https://doi.org/10.3748/wjg.v27.i31.5201
Rajapakse C. Pharyngoesophageal dysphagia: an under recognised, potentially fatal, but very treatable feature of systemic sclerosis. Intern Med J. 2016;46(11):1340-4. https://doi.org/10.1111/imj.13243
Mano T, Soyama S, Sugie K. Improvement in tongue pressure precedes improvement in dysphagia in dermatomyositis. Clin Pract. 2022;12(5):797-802. https://doi.org/10.3390/clinpract12050083
Sun C, Tian X, Li S, Wang G, Lu X. Tongue myositis in dermatomyositis with anti-PM-Scl 75 antibody: two case reports. BMC Musculoskelet Disord. 2025;26(1):868. https://doi.org/10.1186/s12891-025-09114-9
Jaghbeer M, Sutt AL, Bergström L. Dysphagia management and cervical auscultation: reliability and validity against FEES. Dysphagia. 2023;38(1):305-14. https://doi.org/10.1007/s00455-022-10468-8
Silvia A, Speyer R, Cordier R, Windsor C, Korim Ž, Tedla M, et al. Evaluating behavioural interventions for oropharyngeal dysphagia in adults: a systematic review and meta-analysis of swallowing manoeuvres, exercises, and postural techniques. J Clin Med. 2025;14(20):7180. https://doi.org/10.3390/jcm14207180
Speyer R, Cordier R, Sutt AL, Remijn L, Heijnen BJ, Balaguer M, et al. Behavioural interventions in people with oropharyngeal dysphagia: a systematic review and meta-analysis of randomised clinical trials. J Clin Med. 2022;11(3):685. https://doi.org/10.3390/jcm11030685

Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2026 Global Academic Nursing Journal
