Ann Rehabil Med.  2014 Feb;38(1):122-126. 10.5535/arm.2014.38.1.122.

Videofluoroscopy-Guided Balloon Dilatation for the Opening Dysfunction of Upper Esophageal Sphincter by Postoperative Vagus Nerve Injury: A Report on Two Cases

• Jung B
• Choi I
• Lee NJ
• Jung KI
• Yoo WK
• Ohn SH

• KMID: 2266550
• DOI: http://doi.org/10.5535/arm.2014.38.1.122

Abstract

Dysphagia secondary to peripheral cranial nerve injury originates from weak and uncoordinated contraction-relaxation of cricopharyngeal muscle. We report on two patients who suffered vagus nerve injury during surgery and showed sudden dysphagia by opening dysfunction of upper esophageal sphincter (UES). Videofluoroscopy-guided balloon dilatation of UES was performed. We confirmed an early improvement of the opening dysfunctions of UES, although other neurologic symptoms persisted. While we did not have a proper comparison of cases, the videofluoroscopy-guided balloon dilatation of UES is thought to be helpful for the early recovery of dysphagia caused by postoperative vagus nerve injury.

Keyword

Dysphagia; Balloon dilatation; Vagus nerve injuries

MeSH Terms

Cranial Nerve Injuries
Deglutition Disorders
Dilatation*
Esophageal Sphincter, Upper*
Humans
Muscles
Neurologic Manifestations
Vagus Nerve Injuries*
Vagus Nerve*

Figure

• 

  Fig. 1 Videofluoroscopic swallow study images of (A) case 1 patient and (B) case 2 patient before (a, b, c) and after (d, e, f ) videofluoroscopy-guided balloon dilatation of upper esophageal sphincter (UES). Before ballooning, patients showed UES opening dysfunction (A-a, B-a) followed by aspiration (A-b, B-b), and large residue in pyriform sinus (A-c, B-c). After ballooning, we confirmed UES opening improvement (A-d, B-d) without aspiration (A-e, B-e), and decreased pyriform sinus residue (A-f, B-f).

• 

  Fig. 2 Videofluoroscopy-guided balloon dilatation of upper esophageal sphincter (UES). Checking fluoroscopy, Foley catheter with deflated balloon was placed at UES (A), and balloon was inflated using contrast media (B).

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