J Korean Dysphagia Soc.  2017 Jul;7(2):69-75. 10.0000/jkdps.2017.7.2.69.

The Effect of Balloon Dilatation and/or Botulinum Toxin Injection on the Severe Dysphagic Patients with Cricopharyngeal Dysfunction: Case Series

Affiliations
  • 1Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea. keepwiz@gmail.com
  • 2Gangwon Do Rehabilitation Hospital, Chuncheon, Korea.

Abstract


OBJECTIVE
To investigate changes of swallowing function after ballooning dilatation (BD) and the Botox injection (BI) into the cricopharyngeus muscle in patients with severe dysphagia. METHOD: Nine severe dysphagic patients with cricopharyngeal dysfunction (CPD) who underwent BD and/or BI into the cricopharyngeal muscle were retrospectively reviewd. Patients who had severe dysphagia (Functional Oral Intake Scale (FOIS)≤2) after at least 3 months of the conventional swallowing therapy were included by a thorough review of medical records with videofluoroscopic swallowing study (VFSS). Before and after several interventions (BD and/or BI), swallowing function was evaluated using VFSS. RESULT: Among 9 patients, 5 underwent both BD and BI, and the other 4 patients underwent only BD. Four among 9 cases showed that interventions were effective. Of the 5 cases with both BD and BI, 2 cases were effective for treatment of CPD. In all the effective 4 cases, pyriform sinus residue seemed to be related with FOIS. Of those cases, one case had long-term effect (more than 4 months) and the other 3 case had short term effect (less than 4 months).
CONCLUSION
Interventions were effective in 4 among 9 cases with severe CPD and the therapeutic effect was sustained for more than 4 months. The results suggest that in CPD patients, the BD or BI into UES could be considered in selected patients.

Keyword

Botulinum toxin; Cricopharyngeal dilation; Cricopharyngeal dysfunction; Deglutition; Deglutition Disorders; Fluoroscopy
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