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Targeted use of endoscopic CO2 laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment.
J Laryngol Otol. 2014 Dec; 128(12):1105-10.JL

Abstract

BACKGROUND

Cricopharyngeal dysfunction following head and neck cancer treatment may lead to a significant reduction in oral intake. Carbon dioxide laser is an established procedure for the treatment of non-malignant cricopharyngeal disorders. We report our experience of laser cricopharyngeal myotomy with objective swallowing outcome measures, before and after treatment.

METHODS

We identified 11 patients who had undergone carbon dioxide laser cricopharyngeal myotomy for dysphagia following radiotherapy, with or without chemotheraphy between January 2006 and July 2011. We analysed the swallowing outcomes following carbon dioxide laser cricopharyngeal myotomy by retrospective grading of pre- and post-procedure videofluoroscopic swallowing study of liquids, using the validated Modified Barium Swallow Impairment Profile.

RESULTS

The median Modified Barium Swallow Impairment Profile score was 13 pre-myotomy and 10 post-myotomy. This difference between scores was non-significant (p = 0.41). The median, cricopharyngeal-specific Modified Barium Swallow Impairment Profile variables (14 and 17) improved from 3 to 2, but were similarly non-significant (p = 0.16). We observed the improved Modified Barium Swallow Impairment Profile scores post-procedure in the majority of patients.

CONCLUSION

Endoscopic carbon dioxide laser cricopharyngeal myotomy remains a viable option in treatment-related cricopharyngeal dysfunction; its targeted role requires further prospective study. Objective analysis of the technique can be reported using the validated Modified Barium Swallow Impairment Profile.

Authors+Show Affiliations

ENT Department,Sunderland Royal Hospital,UK.Speech and Language Therapy Department,Sunderland Royal Hospital,UK.ENT Department,Sunderland Royal Hospital,UK.ENT Department,Sunderland Royal Hospital,UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25385025

Citation

Dawe, N, et al. "Targeted Use of Endoscopic CO2 Laser Cricopharyngeal Myotomy for Improving Swallowing Function Following Head and Neck Cancer Treatment." The Journal of Laryngology and Otology, vol. 128, no. 12, 2014, pp. 1105-10.
Dawe N, Patterson J, Hamilton D, et al. Targeted use of endoscopic CO2 laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment. J Laryngol Otol. 2014;128(12):1105-10.
Dawe, N., Patterson, J., Hamilton, D., & Hartley, C. (2014). Targeted use of endoscopic CO2 laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment. The Journal of Laryngology and Otology, 128(12), 1105-10. https://doi.org/10.1017/S0022215114002692
Dawe N, et al. Targeted Use of Endoscopic CO2 Laser Cricopharyngeal Myotomy for Improving Swallowing Function Following Head and Neck Cancer Treatment. J Laryngol Otol. 2014;128(12):1105-10. PubMed PMID: 25385025.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Targeted use of endoscopic CO2 laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment. AU - Dawe,N, AU - Patterson,J, AU - Hamilton,D, AU - Hartley,C, Y1 - 2014/11/11/ PY - 2014/11/12/entrez PY - 2014/11/12/pubmed PY - 2015/11/11/medline SP - 1105 EP - 10 JF - The Journal of laryngology and otology JO - J Laryngol Otol VL - 128 IS - 12 N2 - BACKGROUND: Cricopharyngeal dysfunction following head and neck cancer treatment may lead to a significant reduction in oral intake. Carbon dioxide laser is an established procedure for the treatment of non-malignant cricopharyngeal disorders. We report our experience of laser cricopharyngeal myotomy with objective swallowing outcome measures, before and after treatment. METHODS: We identified 11 patients who had undergone carbon dioxide laser cricopharyngeal myotomy for dysphagia following radiotherapy, with or without chemotheraphy between January 2006 and July 2011. We analysed the swallowing outcomes following carbon dioxide laser cricopharyngeal myotomy by retrospective grading of pre- and post-procedure videofluoroscopic swallowing study of liquids, using the validated Modified Barium Swallow Impairment Profile. RESULTS: The median Modified Barium Swallow Impairment Profile score was 13 pre-myotomy and 10 post-myotomy. This difference between scores was non-significant (p = 0.41). The median, cricopharyngeal-specific Modified Barium Swallow Impairment Profile variables (14 and 17) improved from 3 to 2, but were similarly non-significant (p = 0.16). We observed the improved Modified Barium Swallow Impairment Profile scores post-procedure in the majority of patients. CONCLUSION: Endoscopic carbon dioxide laser cricopharyngeal myotomy remains a viable option in treatment-related cricopharyngeal dysfunction; its targeted role requires further prospective study. Objective analysis of the technique can be reported using the validated Modified Barium Swallow Impairment Profile. SN - 1748-5460 UR - https://www.unboundmedicine.com/medline/citation/25385025/Targeted_use_of_endoscopic_CO2_laser_cricopharyngeal_myotomy_for_improving_swallowing_function_following_head_and_neck_cancer_treatment_ L2 - https://www.cambridge.org/core/product/identifier/S0022215114002692/type/journal_article DB - PRIME DP - Unbound Medicine ER -