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

• Lee WK
• Seo HG
• Seong MY
• Yeom J
• Lee WH
• Han TR
• Oh BM

• KMID: 2394673
• DOI: http://doi.org/10.0000/jkdps.2017.7.2.69

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

MeSH Terms

Botulinum Toxins*
Deglutition
Deglutition Disorders
Dilatation*
Fluoroscopy
Humans
Medical Records
Methods
Pharyngeal Muscles
Pyriform Sinus
Retrospective Studies
Botulinum Toxins