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The Effect of Different Catheter Balloon Dilatation Modes on Cricopharyngeal Dysfunction in Patients with Dysphagia

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Abstract

The primary aim of this study was to investigate the outcomes of two different modes (active and passive) of balloon dilatation therapy on cricopharyngeal dysfunction (CPD). Thirty-eight CPD patients with neurological disorders were recruited between 2006 and 2010. Twenty-one of them received active balloon dilatation therapy, and the remaining 17 received passive dilatation therapy for an average of 4 weeks. The patients’ swallowing function before and after the intervention was evaluated using the Functional Oral Intake Scale (FOIS) and the upper esophageal sphincter (UES) opening was studied with the videofluoroscopic swallow study. Both modes of balloon dilatation therapy yielded improvements in the FOIS (active group: z = −3.767, p < 0.001; passive group: z = −3.472, p < 0.001) and the UES opening (both groups: p < 0.01). Active dilatation showed a significantly better FOIS result (p = 0.028) than passive dilatation for CPD. Both active and passive balloon dilatation benefits patients with neurological disorders but active balloon dilatation is better.

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References

  1. Ali GN, Wallace KL, Laundl TM, Hunt DR, Darle DJ, Cook IJ. Predictors of outcome following cricopharyngeal disruption for pharyngeal dysphagia. Dysphagia. 1997;12:133–9.

    Article  PubMed  CAS  Google Scholar 

  2. Lang IM, Shaker R. Anatomy and physiology of the upper esophageal sphincter. Am J Med. 1997;103:50S–5S.

    Article  PubMed  CAS  Google Scholar 

  3. Lang IM, Shaker R. An overview of the upper esophageal sphincter. Curr Gastroenterol Rep. 2000;2:185–90.

    Article  PubMed  CAS  Google Scholar 

  4. Cook IJ. Clinical disorders of the upper esophageal sphincter. GI Motil Online. 2006. doi:10.1038/gimo37. http://www.nature.com/gimo/contents/pt1/full/gimo37.html. Accessed 7 March 2012

  5. Cook IJ. Diagnosis and management of cricopharyngeal achalasia and other upper esophageal sphincter opening disorders. Curr Gastroenterol Rep. 2000;2:191–5.

    Article  PubMed  CAS  Google Scholar 

  6. Cook IJ, Kahrilas PJ. American Gastroenterological Association technical review on management of oropharyngeal dysphagia. Gastroenterology. 1999;116:455–78.

    Article  PubMed  CAS  Google Scholar 

  7. Brooks A, Millar AJW, Rode H. The surgical management of cricopharyngeal achalasia in children. Int J Pediatr Otolaryngol. 2000;56:1–7.

    Article  CAS  Google Scholar 

  8. Cook IJ, Kahrilas PJ. American Gastroenterological Association medical position statement on management of oropharyngeal dysphagia. Gastroenterology. 1999;116:452–4.

    Article  Google Scholar 

  9. Blitzer A, Brin MF. Use of botulinum toxin for diagnosis and management of cricopharyngeal achalasia. Otolaryngol Head Neck Surg. 1997;116:328–30.

    Article  PubMed  CAS  Google Scholar 

  10. Castell DO, Roberts JR. Management of achalasia in the 21st century: a suggested approach. Pract Gastroenterol. 2010; Jan:26–32. http://www.practicalgastro.com/pdf/January10/CastellArticle.pdf. Accessed 7 March 2012

  11. Wang AY, Kadkade R, Kahrilas PJ, Hirano I. Effectiveness of esophageal dilatation for symptomatic cricopharyngeal bar. Gastrointest Endosc. 2005;61:148–52.

    Article  PubMed  Google Scholar 

  12. Lernau OZ, Sherzer E, Mogle P, Nissan S. Congenital cricopharyngeal achalasia treatment by dilatations. J Pediatr Surg. 1984;19:202–3.

    Article  PubMed  CAS  Google Scholar 

  13. Erdeve O, Kologlu M, Saygili B, Atasay B, Arsan S. Primary cricopharyngeal achalasia in a newborn treated by balloon dilatation: a case report and review of the literature. Int J Pediatr Otolaryngol. 2007;71:165–8.

    Article  Google Scholar 

  14. Solt J, Bajor J, Moizs M, Grexa E, Horvath PO. Primary cricopharyngeal dysfunction: treatment with catheter balloon dilatation. Gastrointest Endosc. 2001;54:767–71.

    Article  PubMed  CAS  Google Scholar 

  15. Nagano H, Yoshifuku K, Kurono Y. Polymyositis with dysphagia treated with endoscopic balloon dilatation. Auris Nasus Larynx. 2009;36:705–8.

    Article  PubMed  Google Scholar 

  16. Rai RR, Shende A, Joshi A, Mathur A, Nijhawan S. Rigiflex pneumatic dilatation of achalasia without fluoroscopy: a novel office procedure. Gastrointest Endosc. 2005;62:427–31.

    Article  PubMed  Google Scholar 

  17. Thomas W, Harish K, Sunilkumar K. Pneumatic dilatation of achalasia cardia under direct endoscopy: the debate continues. Gastrointest Endosc. 2006;63:734.

    Article  PubMed  Google Scholar 

  18. Lambroza A, Schuman RW. Pneumatic dilatation for achalasia without fluoroscopic guidance: safety and efficacy. Am J Gastroenterol. 1995;90:1226–9.

    PubMed  CAS  Google Scholar 

  19. Davis D, Nowicki M, Giles H. Cricopharyngeal achalasia responsive to balloon dilatation in an infant. South Med J. 2005;98:472–4.

    Article  PubMed  Google Scholar 

  20. Riley SA, Attwood SE. Guidelines on the use of oesophageal dilatation in clinical practice. Gut. 2004;53(Suppl 1):i1–6.

    Article  PubMed  Google Scholar 

  21. Egan JV, Baron TH, Adler DG, Davila R, Faigel DO, Gan SL, Hirota WK, Leighton JA, Lichtenstein D, Qureshi WA, Rajan E, Shen B, Zuckerman MJ, VanGuilder T, Fanelli RD. Esophageal dilatation. Gastrointest Endosc. 2006;63:755–60.

    Article  PubMed  Google Scholar 

  22. Dou ZL, Wang GF, Wang XH, Qiu WH, Lin JX, Lin JX, Pan WP. Stretching the cricopharyngeus muscle by urethral catheter balloon dilatation: a novel approach to treating dysphagia caused by cricopharyngeal achalasia. Chin J Phys Med Rehabil. 2006;28:166–70.

    Google Scholar 

  23. Lan Y, Dou ZL, Wang GF, Li X. Efficacy of balloon dilatation therapy for cricopharyngeal achalasia in patients with brainstem lesions. Chin J Phys Med Rehabil. 2009;31:835–8.

    Google Scholar 

  24. Wan GF, Hu XQ, Dou Zl, Lan Y, Xie CQ. Application of balloon dilatation for cricopharyngeal achalasia in children: a case report. Chin J Rehabil Theory Pract. 2010;16:279–80.

    Google Scholar 

  25. Goyal RK, Martin SB, Shapiro J, Spechler SJ. The role of cricopharyngeus muscle in pharyngoesophageal disorders. Dysphagia. 1993;8:252–8.

    Article  PubMed  CAS  Google Scholar 

  26. Lang IM. Upper esophageal sphincter. GI Motil Online. 2006. doi:10.1038/gimo12. http://www.nature.com/gimo/contents/pt1/full/gimo12.html. Accessed 7 March 2012

  27. Carpenter DO. Central nervous system mechanism in deglutition and emesis. In: Wood JD, editor, Handbook of physiology, gastrointestinal system, vol. 4, motility and circulation. Washington, DC: American Physiology Society; 1984.

  28. Crary MA, Mann GD, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005;86:1516–20.

    Article  PubMed  Google Scholar 

  29. Dodds WJ. The physiology of swallowing. Dysphagia. 1989;3:171–8.

    Article  PubMed  CAS  Google Scholar 

  30. Bieger D, Hopkins DA. Viscerotropic representation of the upper alimentary tract in the medulla oblongata in the rat: the nucleus ambiguus. J Comp Neurol. 1987;262:546–62.

    Article  PubMed  CAS  Google Scholar 

  31. Bao X, Wiedner EB, Altschuler SM. Transsynaptic localization of pharyngeal premotor neurons in rat. Brain Res. 1995;696:246–9.

    Article  PubMed  CAS  Google Scholar 

  32. Hudson LC. The origins of innervation of the canine caudal pharyngeal muscles: an HRP study. Brain Res. 1986;374:413–8.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Hongmei Wen.

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Dou, Z., Zu, Y., Wen, H. et al. The Effect of Different Catheter Balloon Dilatation Modes on Cricopharyngeal Dysfunction in Patients with Dysphagia. Dysphagia 27, 514–520 (2012). https://doi.org/10.1007/s00455-012-9402-4

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  • DOI: https://doi.org/10.1007/s00455-012-9402-4

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