Improved symptomatic, functional, and fluoroscopic outcomes following serial “series of three” double-balloon dilation for cricopharyngeus muscle dysfunction
Abstract Background Cricopharyngeus muscle dysfunction (CPMD) is a common cause of dysphagia. We employ a progressive series of three double-balloon dilations separated by 4–6 weeks between procedures as a primary treatment option. The purpose of this study was to evaluate subjective, functional and...
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SAGE Publishing
2018-05-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s40463-018-0278-7 |
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| author | Derrick R. Randall Lisa M. Evangelista Maggie A. Kuhn Peter C. Belafsky |
| author_facet | Derrick R. Randall Lisa M. Evangelista Maggie A. Kuhn Peter C. Belafsky |
| author_sort | Derrick R. Randall |
| collection | DOAJ |
| description | Abstract Background Cricopharyngeus muscle dysfunction (CPMD) is a common cause of dysphagia. We employ a progressive series of three double-balloon dilations separated by 4–6 weeks between procedures as a primary treatment option. The purpose of this study was to evaluate subjective, functional and objective improvement in swallowing after three serial dilations for CPMD. Methods We retrospectively evaluated patients between June 1, 2014, and June 30, 2016, who underwent a series of three double-balloon dilations for CPMD. Pre- and post-dilation Eating Assessment Tool-10 (EAT-10), Functional Oral Intake Scale (FOIS), pharyngeal constriction ratio, pharyngeal area, and pharyngoesophageal segment (PES) opening were compared. Results Seventeen patients with CPMD underwent serial double-balloon dilation procedures separated by one month. Mean age of the cohort was 73.5 (SD ± 13.3) years, and 53% were female. The mean EAT-10 improved from 24.7 (SD ± 7.8) to 15.9 (SD ± 10.2) [p = 0.0021]. Mean FOIS improved from 5.4 (SD ± 1.4) pre- to 6.3 (SD ± 0.9) post-treatment (p = 0.017). Mean UES opening increased from 1.05 (SD ± 0.34) cm to 1.48 (SD ± 0.41) cm (p = 0.0003) in the anteroposterior fluoroscopic view and from 0.58 (SD ± 0.18) to 0.76 (SD ± 0.30) cm (p = 0.018) in the lateral view. Pharyngeal constriction ratio (PCR), a surrogate measure of pharyngeal strength, improved from 0.49 (SD ± 0.37) to 0.24 (SD ± 0.15) (p = 0.015), however pharyngeal area (PA) was unchanged. Conclusions A progressive series of three double-balloon dilations for cricopharyngeus muscle dysfunction resulted in improved patient reported dysphagia symptom scores and objective fluoroscopic swallowing parameters. |
| format | Article |
| id | doaj-art-77116fd3119047b68358075443e95aa7 |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2018-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-77116fd3119047b68358075443e95aa72025-01-03T01:45:58ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162018-05-014711810.1186/s40463-018-0278-7Improved symptomatic, functional, and fluoroscopic outcomes following serial “series of three” double-balloon dilation for cricopharyngeus muscle dysfunctionDerrick R. Randall0Lisa M. Evangelista1Maggie A. Kuhn2Peter C. Belafsky3Center for Voice and Swallowing, Department of Otolaryngology – Head & Neck Surgery, University of California DavisCenter for Voice and Swallowing, Department of Otolaryngology – Head & Neck Surgery, University of California DavisCenter for Voice and Swallowing, Department of Otolaryngology – Head & Neck Surgery, University of California DavisCenter for Voice and Swallowing, Department of Otolaryngology – Head & Neck Surgery, University of California DavisAbstract Background Cricopharyngeus muscle dysfunction (CPMD) is a common cause of dysphagia. We employ a progressive series of three double-balloon dilations separated by 4–6 weeks between procedures as a primary treatment option. The purpose of this study was to evaluate subjective, functional and objective improvement in swallowing after three serial dilations for CPMD. Methods We retrospectively evaluated patients between June 1, 2014, and June 30, 2016, who underwent a series of three double-balloon dilations for CPMD. Pre- and post-dilation Eating Assessment Tool-10 (EAT-10), Functional Oral Intake Scale (FOIS), pharyngeal constriction ratio, pharyngeal area, and pharyngoesophageal segment (PES) opening were compared. Results Seventeen patients with CPMD underwent serial double-balloon dilation procedures separated by one month. Mean age of the cohort was 73.5 (SD ± 13.3) years, and 53% were female. The mean EAT-10 improved from 24.7 (SD ± 7.8) to 15.9 (SD ± 10.2) [p = 0.0021]. Mean FOIS improved from 5.4 (SD ± 1.4) pre- to 6.3 (SD ± 0.9) post-treatment (p = 0.017). Mean UES opening increased from 1.05 (SD ± 0.34) cm to 1.48 (SD ± 0.41) cm (p = 0.0003) in the anteroposterior fluoroscopic view and from 0.58 (SD ± 0.18) to 0.76 (SD ± 0.30) cm (p = 0.018) in the lateral view. Pharyngeal constriction ratio (PCR), a surrogate measure of pharyngeal strength, improved from 0.49 (SD ± 0.37) to 0.24 (SD ± 0.15) (p = 0.015), however pharyngeal area (PA) was unchanged. Conclusions A progressive series of three double-balloon dilations for cricopharyngeus muscle dysfunction resulted in improved patient reported dysphagia symptom scores and objective fluoroscopic swallowing parameters.http://link.springer.com/article/10.1186/s40463-018-0278-7DysphagiaCricopharyngeus muscle dysfunctionOtolaryngologyLaryngologySwallowingTransnasal esophagoscopy |
| spellingShingle | Derrick R. Randall Lisa M. Evangelista Maggie A. Kuhn Peter C. Belafsky Improved symptomatic, functional, and fluoroscopic outcomes following serial “series of three” double-balloon dilation for cricopharyngeus muscle dysfunction Journal of Otolaryngology - Head and Neck Surgery Dysphagia Cricopharyngeus muscle dysfunction Otolaryngology Laryngology Swallowing Transnasal esophagoscopy |
| title | Improved symptomatic, functional, and fluoroscopic outcomes following serial “series of three” double-balloon dilation for cricopharyngeus muscle dysfunction |
| title_full | Improved symptomatic, functional, and fluoroscopic outcomes following serial “series of three” double-balloon dilation for cricopharyngeus muscle dysfunction |
| title_fullStr | Improved symptomatic, functional, and fluoroscopic outcomes following serial “series of three” double-balloon dilation for cricopharyngeus muscle dysfunction |
| title_full_unstemmed | Improved symptomatic, functional, and fluoroscopic outcomes following serial “series of three” double-balloon dilation for cricopharyngeus muscle dysfunction |
| title_short | Improved symptomatic, functional, and fluoroscopic outcomes following serial “series of three” double-balloon dilation for cricopharyngeus muscle dysfunction |
| title_sort | improved symptomatic functional and fluoroscopic outcomes following serial series of three double balloon dilation for cricopharyngeus muscle dysfunction |
| topic | Dysphagia Cricopharyngeus muscle dysfunction Otolaryngology Laryngology Swallowing Transnasal esophagoscopy |
| url | http://link.springer.com/article/10.1186/s40463-018-0278-7 |
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