ENT MANIFESTATIONS IN A PARKINSON'S DISEASE PATIENT

Today April 11 th is celebrated as 'World Parkinson's Disease Day '. Parkinson's disease is a progressive neurodegenerative disease  affecting a part of brain called basal ganglia along with deficiency of neurotransmitter. It is characterized by resting tremors, rigidity  of the muscles and slowness of movement. 

ENT  MANIFESTATIONS

The patients present with decrease or loss of smell, drooling of saliva, decreased facial expressions ,vocal tremors, weakness, soft voice and difficulty in articulation of speech. This  difficulty in phonation is known as dysphonia. 

DYSPHAGIA or difficulty in swallowing is another problem faced by Parkinson's disease patient. It is due to changes in the voluntary and involuntary muscles and their neural control. The stages of swallow affected are oral preparatory stage and pharyngeal stage. Oral preparatory stage is affected  due to the tongue muscle rigidity, thereby tongue cannot change it's shape and propulsion of food into the oropharynx is affected. There will be delayed contraction of pharyngeal muscles . 

Patient will have impaired  or defective motility, stasis or retention of food in the hypopharynx( part behind the larynx).

 Another problem is poor movement of epiglottis which closes the laryngeal or upper airway inlet, thereby  causing ASPIRATION of food into the larynx. The laryngeal protective function is affected.  So there will be recurrent respiratory tract infections, like aspiration pneumonia. 

SO WHEN A PARKINSONS DISEASE PATIENT COMES TO AN ENT ONE HAS TO LOOK FOR THE ABOVE MENTIONED PROBLEMS.