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Management of isolated cricopharyngeal dysfunction: systematic review

Published online by Cambridge University Press:  19 May 2016

A Ashman ,
O T Dale  and
D L Baldwin
A Ashman*
Affiliation:
ENT Department, St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust, UK
O T Dale
Affiliation:
ENT Department, Gloucestershire Royal Hospital, Gloucestershire Hospitals NHS Foundation Trust, UK
D L Baldwin
Affiliation:
ENT Department, St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust, UK
*
Address for correspondence: Mr A Ashman, ENT Department, St Michael's Hospital, Southwell Street, Bristol BS2 8EG, UK Fax: 0117 342 5262 E-mail: [email protected]
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Abstract

Objective:

A systematic review was performed to evaluate the safety and efficacy of different therapeutic interventions available for the management of isolated cricopharyngeal dysfunction.

Methods:

Studies were identified using the following databases: Ovid (Medline, Embase), the Cochrane Library, PubMed and Google Scholar. An initial search identified 339 articles. All titles and abstracts were reviewed. Fifty-six relevant articles were inspected in more detail; of these, 47 were included in the qualitative analysis.

Results:

No relevant randomised trials were found. A range of case series were used to perform a qualitative analysis. Botulinum toxin A injection and cricopharyngeal dilatation were associated with a higher risk of recurrence, but appear to be more suitable in elderly and co-morbid patients. In those patients requiring formal myotomy, endoscopic approaches appear to be as effective but less morbid when compared with classical open surgery.

Conclusion:

There is good evidence for the safety and efficacy of the different therapeutic options for isolated cricopharyngeal dysfunction. However, further studies are required to compare the efficacy of the various treatment modalities.

Keywords

Pharyngeal MusclesPhysiopathologyHypertrophyLaser TherapyBotulinum Toxins, Type A
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 7 , July 2016 , pp. 611 - 615
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1Halvorson, DJ, Kuhn, FA.Transmucosal cricopharyngeal myotomy with the potassium-titanyl-phosphate laser in the treatment of cricopharyngeal dysmotility. Ann Otol Rhinol Laryngol 1994;103:173–7CrossRefGoogle ScholarPubMed
2Tieu, BH, Hunter, JG.Management of cricopharyngeal dysphagia with and without Zenker's diverticulum. Thorac Surg Clin 2011;21:511–17CrossRefGoogle ScholarPubMed
3Moher, D, Liberati, A, Tetzlaff, J, Altman, DG; PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. BMJ 2009;339:b2535CrossRefGoogle ScholarPubMed
4Manison, N.Efficacy or expediency? An examination of the role of cricopharyngeal myotomy. Asia Pac J Speech Lang Hear 2003;8:116–30CrossRefGoogle Scholar
5Halvorson, DJ.The treatment of cricopharyngeal dysmotility with a transmucosal cricopharyngeal myotomy using the potassium-titanyl-phosphate (KTP) laser. Endoscopy 1998;30:46–50CrossRefGoogle ScholarPubMed
6Lawson, G, Remacle, M.Endoscopic cricopharyngeal myotomy: indications and technique. Curr Opin Otolaryngol Head Neck Surg 2006;14:437–41CrossRefGoogle ScholarPubMed
7Brøndbo, K.Treatment of cricopharyngeal dysfunction by endoscopic laser. Acta Otolaryngol Suppl 2000;543:222–4CrossRefGoogle ScholarPubMed
8Mason, RJ, Bremner, CG, DeMeester, TR, Crookes, PF, Peters, JH, Hagen, JA et al. Pharyngeal swallowing disorders: selection for and outcome after myotomy. Ann Surg 1998;228:598–608CrossRefGoogle ScholarPubMed
9Ozgursoy, OB, Salassa, JR.Manofluorographic and functional outcomes after endoscopic laser cricopharyngeal myotomy for cricopharyngeal bar. Otolaryngol Head Neck Surg 2010;142:735–40CrossRefGoogle ScholarPubMed
10Solt, J, Bajor, J, Moizs, M, Grexa, E, Horváth, PO.Primary cricopharyngeal dysfunction: treatment with balloon catheter dilatation. Gastrointest Endosc 2001;54:767–71CrossRefGoogle ScholarPubMed
11Kaplan, S.Paralysis of deglutition. A post-poliomyelitis complication treated by section of the cricopharyngeus muscle. Ann Surg 1951;133:572–3CrossRefGoogle ScholarPubMed
12Mosher, HP.Webs and pouches of the esophagus, their diagnosis and treatment. Surg Gynecol Obstet 1917;25:175–87Google Scholar
13Dohlman, G.Endoscopic operations for hypopharyngeal diverticula. In: Proceedings of the Fourth International Congress on Otolaryngology. London: British Medical Association, 1948;715–17Google Scholar
14van Overbeek, JJ, Hoeksema, PE, Edens, ET.Microendoscopic surgery of the hypopharyngeal diverticulum using electrocoagulation or carbon dioxide laser. Ann Otol Rhinol Laryngol 1984;93:34–6CrossRefGoogle ScholarPubMed
15Fama, AF, Moore, EJ, Kasperbauer, JL.Harmonic scalpel in the treatment of Zenker's diverticulum. Laryngoscope 2009;119:1265–9CrossRefGoogle ScholarPubMed
16Dale, OT, Mackeith, S, Burgess, CA, Rourke, TJ, Winter, SC, Corbridge, RJ.Functional outcomes following endoscopic laser cricopharyngeal myotomy with mucosal repair. Eur Arch Otorhinolaryngol 2014;271:1631–4CrossRefGoogle ScholarPubMed
17Altman, JI, Genden, EM, Moche, J.Fiberoptic endoscopic-assisted diverticulotomy: a novel technique for the management of Zenker's diverticulum. Ann Otol Rhinol Laryngol 2005;114:347–51CrossRefGoogle ScholarPubMed
18Pollei, TR, Hinni, ML, Hayden, RE, Lott, DG, Mors, MB.Comparison of carbon dioxide laser-assisted versus stapler-assisted endoscopic cricopharyngeal myotomy. Ann Otol Rhinol Laryngol 2013;122:568–74CrossRefGoogle ScholarPubMed
19Kuhn, FA, Bent, JP 3rd. Zenker's diverticulotomy using the KTP/532 laser. Laryngoscope 1992;102:946–50CrossRefGoogle ScholarPubMed
20Schneider, I, Thumfart, WF, Pototschnig, C, Eckel, HE.Treatment of dysfunction of the cricopharyngeal muscle with botulinum A toxin: introduction of a new, noninvasive method. Ann Otol Rhinol Laryngol 1994;103:31–5CrossRefGoogle ScholarPubMed
21Brady, AP, Stevenson, GW, Somers, S, Hough, DM, Di Giandomenico, E.Premature contraction of the cricopharyngeus: a new sign of gastroesophageal reflux disease. Abdom Imaging 1995;20:225–9CrossRefGoogle ScholarPubMed
22Jones, CA, Knigge, MA, McCulloch, TM.Speech pathologist practice patterns for evaluation and management of suspected cricopharyngeal dysfunction. Dysphagia 2014;29:332–9CrossRefGoogle ScholarPubMed
23Atkinson, SI, Rees, J.Botulinum toxin for cricopharyngeal dysphagia: case reports of CT-guided injection. J Otolaryngol 1997;26:273–6Google ScholarPubMed
24Kelly, EA, Koszewski, IJ, Jaradeh, SS, Merati, AL, Blumin, JH, Bock, JM.Botulinum toxin injection for the treatment of upper esophageal sphincter dysfunction. Ann Otol Rhinol Laryngol 2013;122:100–8CrossRefGoogle ScholarPubMed
25Belafsky, PC, Mouadeb, DA, Rees, CJ, Pryor, JC, Postma, GN, Allen, J et al. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol 2008;117:919–24CrossRefGoogle ScholarPubMed
26Wang, AY, Kadkade, R, Kahrilas, PJ, Hirano, I.Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar. Gastrointest Endosc 2005;61:148–52CrossRefGoogle ScholarPubMed
27Chandrasekhara, V, Koh, J, Lattimer, L, Dundar, KB, Ravich, W, Clarke, JO.Dilatation of the upper esophageal sphincter via retrograde or static technique is safe and effective: results of a retrospective analysis from 2006–2009 at a tertiary referral center. Gastrointest Endosc 2010;71:AB174CrossRefGoogle Scholar
28Zulin, D, Wen, HM.Effect of balloon dilatation therapy in patients with cricopharyngeal dysfunction. Dysphagia 2011;26:439Google Scholar
29Clary, MS, Daniero, JJ, Keith, SW, Boon, MS, Spiegel, JR.Efficacy of large-diameter dilatation in cricopharyngeal dysfunction. Laryngoscope 2011;121:2521–5CrossRefGoogle ScholarPubMed
30Beswick, L, Boyapati, R, Robertson, M, Crantock, L.Is empirical oesophageal dilatation useful in patients with dysphagia and negative gastroscopy? J Gastroenterol Hepatol 2012;27:52Google Scholar
31Dou, Z, Zu, Y, Wen, H, Wan, G, Jiang, L, Hu, Y.The effect of different catheter balloon dilatation modes on cricopharyngeal dysfunction in patients with dysphagia. Dysphagia 2012;27:514–20CrossRefGoogle ScholarPubMed
32Patel, BJ, Mathur, AK, Dehom, S, Jackson, CS.Savary dilation is a safe and effective long-term means of treatment of symptomatic cricopharyngeal bar: a single-center experience. J Clin Gastroenterol 2014;48:500–4CrossRefGoogle ScholarPubMed
33Salassa, JR.A functional outcome swallowing scale for staging oropharyngeal dysphagia. Dig Dis 1999;17:230–4CrossRefGoogle ScholarPubMed
34Brigand, C, Ferraro, P, Martin, J, Duranceau, A.Risk factors in patients undergoing cricopharyngeal myotomy. Br J Surg 2007;94:978–83CrossRefGoogle ScholarPubMed
35Ho, AS, Morzaria, S, Damrose, EJ.Carbon dioxide laser-assisted endoscopic cricopharyngeal myotomy with primary mucosal closure. Ann Otol Rhinol Laryngol 2011;120:33–9CrossRefGoogle ScholarPubMed
36Mortensen, M, Schabery, MR, Genden, EM, Woo, P.Transoral resection of short segment Zenker's diverticulum and cricopharyngeal myotomy: an alternative minimally invasive approach. Laryngoscope 2010;120:17–22CrossRefGoogle ScholarPubMed
37Takes, RP, Van Den Hoogen, FA, Henri, A, Marres, M.Endoscopic myotomy of the cricopharyngeal muscle with CO2 laser surgery. Head Neck 2005;27:703–9CrossRefGoogle ScholarPubMed
38Lawson, G, Remacle, M, Jamart, J, Keghian, J.Endoscopic CO2 laser-assisted surgery for cricopharyngeal dysfunction. Eur Arch Otorhinolaryngol 2003;260:475–80CrossRefGoogle ScholarPubMed
39Lim, RY.Endoscopic CO2 laser cricopharyngeal myotomy. J Clin Laser Med Surg 1995;13:241–7CrossRefGoogle ScholarPubMed
40Bergeron, J, Chhetri, D.Indications and outcomes of endoscopic CO2 laser cricopharyngeal myotomy. Laryngoscope 2014;124:950–4CrossRefGoogle ScholarPubMed
41Dauer, E, Salassa, J, Iuga, L, Kasperbauer, J.Endoscopic laser vs open approach for cricopharyngeal myotomy. Otolaryngol Head Neck Surg 2006;134:830–5CrossRefGoogle ScholarPubMed
42Pitman, M, Weissbrod, P.Endoscopic CO2 laser cricopharyngeal myotomy. Laryngoscope 2009;119:45–53CrossRefGoogle ScholarPubMed
43Halland, M, Baron, TH.Flexible endoscopic management of Zenker's diverticulum: characteristics and outcomes of 52 cases. Gastrointest Endosc 2014;79:AB514CrossRefGoogle Scholar
44Arenaz Bua, B, Olsson, R, Westin, U, Rydell, R, Ekberg, O.Treatment of cricopharyngeal dysfunction: a comparative study. BMC Res Notes 2015;8:301CrossRefGoogle Scholar