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Failure of cricopharyngeal myotomy to improve dysphagia following head and neck cancer surgery.
Arch Otolaryngol Head Neck Surg. 1999 Sep; 125(9):942-6.AO

Abstract

OBJECTIVE

To determine whether cricopharyngeal myotomy can improve dysphagia associated with head and neck cancer surgery.

DESIGN

Prospective, randomized, multicenter trial.

SETTING

Twelve clinical sites across the United States.

PATIENTS

Between 1989 and 1994, 125 patients undergoing combined modality therapy for head and neck cancer, including resection of the tongue base or supraglottic larynx, were prospectively entered into the trial.

INTERVENTION

Cricopharyngeal myotomy on a randomized basis.

MAIN OUTCOME MEASURES

Videofluoroscopic examination to determine oropharyngeal swallowing efficiency, which is defined as the ratio of percentage of the bolus swallowed to total swallowing time using 3 different bolus consistencies.

RESULTS

No significant difference in oropharyngeal swallowing efficiency between myotomy vs no myotomy was seen at 6 months of follow-up regardless of bolus consistency.

CONCLUSIONS

In this prospective test of cricopharyngeal myotomy, the procedure fails to significantly improve dysphagia associated with head and neck cancer surgery. The efficacy of this surgical procedure in other disease entities should also be rigorously explored.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, Mich 48201, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10488976

Citation

Jacobs, J R., et al. "Failure of Cricopharyngeal Myotomy to Improve Dysphagia Following Head and Neck Cancer Surgery." Archives of Otolaryngology--head & Neck Surgery, vol. 125, no. 9, 1999, pp. 942-6.
Jacobs JR, Logemann J, Pajak TF, et al. Failure of cricopharyngeal myotomy to improve dysphagia following head and neck cancer surgery. Arch Otolaryngol Head Neck Surg. 1999;125(9):942-6.
Jacobs, J. R., Logemann, J., Pajak, T. F., Pauloski, B. R., Collins, S., Casiano, R. R., & Schuller, D. E. (1999). Failure of cricopharyngeal myotomy to improve dysphagia following head and neck cancer surgery. Archives of Otolaryngology--head & Neck Surgery, 125(9), 942-6.
Jacobs JR, et al. Failure of Cricopharyngeal Myotomy to Improve Dysphagia Following Head and Neck Cancer Surgery. Arch Otolaryngol Head Neck Surg. 1999;125(9):942-6. PubMed PMID: 10488976.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Failure of cricopharyngeal myotomy to improve dysphagia following head and neck cancer surgery. AU - Jacobs,J R, AU - Logemann,J, AU - Pajak,T F, AU - Pauloski,B R, AU - Collins,S, AU - Casiano,R R, AU - Schuller,D E, PY - 1999/9/17/pubmed PY - 1999/9/17/medline PY - 1999/9/17/entrez SP - 942 EP - 6 JF - Archives of otolaryngology--head & neck surgery JO - Arch. Otolaryngol. Head Neck Surg. VL - 125 IS - 9 N2 - OBJECTIVE: To determine whether cricopharyngeal myotomy can improve dysphagia associated with head and neck cancer surgery. DESIGN: Prospective, randomized, multicenter trial. SETTING: Twelve clinical sites across the United States. PATIENTS: Between 1989 and 1994, 125 patients undergoing combined modality therapy for head and neck cancer, including resection of the tongue base or supraglottic larynx, were prospectively entered into the trial. INTERVENTION: Cricopharyngeal myotomy on a randomized basis. MAIN OUTCOME MEASURES: Videofluoroscopic examination to determine oropharyngeal swallowing efficiency, which is defined as the ratio of percentage of the bolus swallowed to total swallowing time using 3 different bolus consistencies. RESULTS: No significant difference in oropharyngeal swallowing efficiency between myotomy vs no myotomy was seen at 6 months of follow-up regardless of bolus consistency. CONCLUSIONS: In this prospective test of cricopharyngeal myotomy, the procedure fails to significantly improve dysphagia associated with head and neck cancer surgery. The efficacy of this surgical procedure in other disease entities should also be rigorously explored. SN - 0886-4470 UR - https://www.unboundmedicine.com/medline/citation/10488976/Failure_of_cricopharyngeal_myotomy_to_improve_dysphagia_following_head_and_neck_cancer_surgery_ L2 - https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/vol/125/pg/942 DB - PRIME DP - Unbound Medicine ER -