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KMID : 0602820130190010019
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Korean Journal of Bronchoesophagology
2013 Volume.19 No. 1 p.19 ~ p.24
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Office-Based EMG-Guided Botox Injection to Cricopharyngeus Muscle in ENT Clinic
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Kim Hyun-Sung
Chung Eun-Jae
Rho Young-Soo
Park Dong-Sik
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Abstract
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Objective: The objective was to evaluate changes in swallow safety and dietary status after the transcutaneous injection of botulinum toxin into the upper esophageal sphincter in a series of outpatients with dysphagia.
Methods: Patients who were at risk for aspiration and who had an unsuccessful trial of swallowing therapy were admitted to the study. All patients showed significant pooling of fluids in the pyriform sinus. All patients were treated in the office; none had previous esophageal dilatation. The upper border of the cricoid cartilage was identified using standard electromyogram procedures and botulinum toxin was injected. Outcomes were assessed using the penetration-aspiration scale, NIH swallowiwng safety score, patients’ short-term and long-term subjective impressions of their ability to swallow, and change in dietary status.
Results: Ten patients underwent an instrumental evaluation of swallowing function. Of the 10 patients, 9 showed an overall improvement in their ability to take an oral diet safely. The penetration-aspiration scale, NIH swallowiwng safety score, patients’ short-term and long-term subjective impressions of their ability to swallow, and change in dietary status were significantly improved after office-based botox injection.
Conclusion: Office-based EMG guided botox injection to the cricopharyngeus muscle is a simple, safe, and effective tool for dysphagia patients. Injection of Botox in the office should be considered when the dysphagia pattern is aspiration after swallow.
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KEYWORD
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Cricopharyngeus muscle, Botox
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