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Assessment of videofluoroscopic swallow study findings before and after cricopharyngeal myotomy.
Head Neck. 2017 09; 39(9):1869-1875.HN

Abstract

BACKGROUND

Cricopharyngeal myotomy is a treatment for obstructive cricopharyngeal bar and Zenker's diverticulitis. Little is reported regarding contrast study findings and their correlation with patient symptoms.

METHODS

All patients treated by cricopharyngeal myotomy underwent a preoperative and postoperative videofluoroscopic swallow study (VFSS) and completed the self-reported Eating Assessment Tool (EAT-10). Studies were analyzed quantitatively.

RESULTS

Forty cricopharyngeal myotomies were performed (mean age 76 years; SD 8.72) all for dysphagia. Symptomatic improvement (change in EAT-10 scores) occurred in 95% (38/40). Presurgical versus postsurgical VFSS demonstrated significantly improved pharyngoesophageal segment opening, pharyngeal constriction ratio, and pouch residue (P < .01). Symptomatic improvement was unrelated to the presence of retained barium.

CONCLUSION

Both symptomatic and objective improvement in swallowing measures occurs after cricopharyngeal myotomy. Pouch remnants and retained barium are seen postoperatively but do not correlate with reported symptoms. Routine follow-up barium studies may be needed to establish a new baseline and allow for comparison if future symptom recurrence occurs.

Authors+Show Affiliations

Department of Otolaryngology, Waitemata District Health Board, Auckland, New Zealand. Department of Surgery, University of Auckland, Auckland, New Zealand.Department of Otolaryngology, Waitemata District Health Board, Auckland, New Zealand.Department of Speech Science, Psychology, and Science, University of Auckland, Auckland, New Zealand.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28644552

Citation

Allen, Jacqui, et al. "Assessment of Videofluoroscopic Swallow Study Findings Before and After Cricopharyngeal Myotomy." Head & Neck, vol. 39, no. 9, 2017, pp. 1869-1875.
Allen J, Blair D, Miles A. Assessment of videofluoroscopic swallow study findings before and after cricopharyngeal myotomy. Head Neck. 2017;39(9):1869-1875.
Allen, J., Blair, D., & Miles, A. (2017). Assessment of videofluoroscopic swallow study findings before and after cricopharyngeal myotomy. Head & Neck, 39(9), 1869-1875. https://doi.org/10.1002/hed.24846
Allen J, Blair D, Miles A. Assessment of Videofluoroscopic Swallow Study Findings Before and After Cricopharyngeal Myotomy. Head Neck. 2017;39(9):1869-1875. PubMed PMID: 28644552.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of videofluoroscopic swallow study findings before and after cricopharyngeal myotomy. AU - Allen,Jacqui, AU - Blair,Dora, AU - Miles,Anna, Y1 - 2017/06/23/ PY - 2017/01/21/received PY - 2017/02/21/revised PY - 2017/04/25/accepted PY - 2017/6/24/pubmed PY - 2018/6/2/medline PY - 2017/6/24/entrez KW - cricopharyngeal dysfunction KW - cricopharyngeal myotomy KW - deglutition KW - dysphagia KW - videofluoroscopy SP - 1869 EP - 1875 JF - Head & neck JO - Head Neck VL - 39 IS - 9 N2 - BACKGROUND: Cricopharyngeal myotomy is a treatment for obstructive cricopharyngeal bar and Zenker's diverticulitis. Little is reported regarding contrast study findings and their correlation with patient symptoms. METHODS: All patients treated by cricopharyngeal myotomy underwent a preoperative and postoperative videofluoroscopic swallow study (VFSS) and completed the self-reported Eating Assessment Tool (EAT-10). Studies were analyzed quantitatively. RESULTS: Forty cricopharyngeal myotomies were performed (mean age 76 years; SD 8.72) all for dysphagia. Symptomatic improvement (change in EAT-10 scores) occurred in 95% (38/40). Presurgical versus postsurgical VFSS demonstrated significantly improved pharyngoesophageal segment opening, pharyngeal constriction ratio, and pouch residue (P < .01). Symptomatic improvement was unrelated to the presence of retained barium. CONCLUSION: Both symptomatic and objective improvement in swallowing measures occurs after cricopharyngeal myotomy. Pouch remnants and retained barium are seen postoperatively but do not correlate with reported symptoms. Routine follow-up barium studies may be needed to establish a new baseline and allow for comparison if future symptom recurrence occurs. SN - 1097-0347 UR - https://www.unboundmedicine.com/medline/citation/28644552/Assessment_of_videofluoroscopic_swallow_study_findings_before_and_after_cricopharyngeal_myotomy_ L2 - https://doi.org/10.1002/hed.24846 DB - PRIME DP - Unbound Medicine ER -