Korean J Gastroenterol.  2014 May;63(5):325-328. 10.4166/kjg.2014.63.5.325.

Treatments with Balloon Catheter Dilatation and Botulium Toxin Injection in a Patient with Pharyngeal Dysphagia Secondary to Cricopharyngeal Dysfunction

• Oh TH

• KMID: 2155333
• DOI: http://doi.org/10.4166/kjg.2014.63.5.325

Abstract

No abstract available.

MeSH Terms

Adult
Botulinum Toxins/*therapeutic use
Brain Infarction/diagnosis/therapy
Deglutition Disorders/diagnosis/physiopathology/*therapy
Dilatation
Esophagoscopy
Humans
Male
Microscopy, Video
Pharyngeal Muscles/*physiopathology
Pharynx/*physiopathology
Botulinum Toxins

Figure

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  Fig. 1. Video-fluoroscopic swallowing study shows retained barium residue on vallecular and pyriform sinus.

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  Fig. 2. Sequential change of manometric findings in high resolution esophageal manometry. (A) Initial findings show decreased contractile pressure of pharyngeal muscle with aperistalsis (black arrow), lack of pharyngoesophageal coordination, and incomplete relaxation of upper esophageal sphincter (asterisk), resulting in hindrance of bolus transit. (B) Follow-up study after Botulinum toxin injection shows decreased resting and residual pressure of upper esophageal sphincter during deglutition (asterisk), resulting in complete bolus transit. However, contractile pressures of hypopharynx (black arrow) and proximal segment of esophageal body (arrowhead) near upper esophageal sphincter are also decreased compared to the initial study.

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  Fig. 3. Endoscopic treatment of secondary cricopharyngeal dysfunction.(A) Under deep sedation, upper esophageal sphincter was dilated with a 20-mm controlled radial expansion balloon catheter for 2 minutes. (B) Diluted solution, equivalent to 100 U Botulinum toxin A, was injected with an endoscopic sclerosis needle at the upper esophageal sphincter level.

Reference

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