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KMID : 1024320160060010042
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Journal of the Korean Dysphagia Society
2016 Volume.6 No. 1 p.42 ~ p.47
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Combination Technique with Ultrasonography and Electromyography for Botulinum Injection in the Cricopharyngeal Muscle: A Case Report
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이상억:Lee Sang-Eok
김병희:Kim Byung-Hee/심희정:Sim Hee-Jung/허진희:Heo Jin-Hee/손석일:Son Seok-Il/김민솔:Kim Min-Sol/황성혜:Hwang Seong-Hye/김효정:Kim Hyo-Jung
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Abstract
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Cricopharygeal dysfunction (CPD) may lead to a range of symptoms including dysphagia and aspiration. Treatments for CPD have included mechanical dilation, myotomy and botulinum injection. Recently, the use of botulinum toxin injection has been reported to be safe and effective for the treatment of CPD. Ultrasonography guided technique, however, is not well established. A 55-year-old woman visited the hospital with a left cerebellar, lateral medullary, and pons infarct 4 years ago. A three-year conventional dysphagia therapy had not improved the patient’s condition. Nutrition had been provided via a percutaneous endoscopic gastrostomy (PEG) tube. Videofluoroscopic swallowing study (VFSS) showed CPD. Ultrasonography and elelctromyography-guided injection of 20 units of botulinum (Meditoxinⓡ) in left cricopharyngeal muscle. One month after injection, the VFSS showed improvement in relaxation of the upper esophageal sphincter. The patient could eat semisolid food and a soft diet at 1,200 kcal/day orally; the treatment was a success.
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KEYWORD
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Cricopharyngeal dysfunction, Botulium toxins, Ultrasonography, Electromyography, Dysphagia
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