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Endoscopic-guided injection of botulinum toxin into the cricopharyngeus muscle: our experience

Published online by Cambridge University Press:  08 October 2015

S D Sharma ,
G Kumar ,
A Eweiss ,
P Chatrath  and
H Kaddour
S D Sharma*
Affiliation:
Department of Otorhinolaryngology, Queen's Hospital, Romford, UK
G Kumar
Affiliation:
Department of Otorhinolaryngology, Queen's Hospital, Romford, UK
A Eweiss
Affiliation:
Department of Otorhinolaryngology, Queen's Hospital, Romford, UK
P Chatrath
Affiliation:
Department of Otorhinolaryngology, Queen's Hospital, Romford, UK
H Kaddour
Affiliation:
Department of Otorhinolaryngology, Queen's Hospital, Romford, UK
*
Address for correspondence: Mr Sunil D Sharma, Department of Otorhinolaryngology, Queen's Hospital, Rom Valley Way, Romford RM7 0AG, UK Fax: +44 (0)1708 435096 E-mail: [email protected]
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Abstract

Objective:

To assess the efficacy of endoscopic-guided botulinum toxin injection into the cricopharyngeus muscle and evaluate the duration of its effects.

Methods:

A 3-year prospective study of 12 patients undergoing injection of botulinum toxin was conducted, with a telephone survey to assess dysphagia pre-operatively, and at 1, 3 and 6 months post-treatment, using the MD Anderson Dysphagia Inventory.

Results:

Median age was 66.2 years. Causes of cricopharyngeal dysphagia included idiopathic cricopharyngeal hypertrophy (67 per cent), previous cerebrovascular accident (17 per cent), cranial nerve palsy (8 per cent) and previous chemoradiotherapy to the neck (8 per cent). There were no complications. Two patients had repeat injections after six months. There was significant improvement in MD Anderson Dysphagia Inventory scores at one and three months versus pre-operative scores (73.1 ± 14.9 vs 46.9 ± 7.6, p = 0.0001, and 65.1 ± 11.5 vs 46.9 ± 7.6, p = 0.0001), but not at six months (51.0 ± 11.0 vs 46.9 ± 7.6, p = 0.14).

Conclusion:

Endoscopic-guided injection of botulinum toxin into the cricopharyngeus muscle is a safe and effective method for treating cricopharyngeal muscle dysfunction, lasting up to six months.

Keywords

Botulinum ToxinCricopharyngeus MuscleDysphagia
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 10 , October 2015 , pp. 990 - 995
Copyright
Copyright © JLO (1984) Limited 2015 

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