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KMID : 1024320170070020069
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Journal of the Korean Dysphagia Society
2017 Volume.7 No. 2 p.69 ~ p.75
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The Effect of Balloon Dilatation and/or Botulinum Toxin Injection on the Severe Dysphagic Patients with Cricopharyngeal Dysfunction: Case Series
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Lee Won-Kyung
Seo Han-Gil
Seong Min-Yong
Yeom Ji-Woon
Lee Woo-Hyung
Han Tai-Ryoon
Oh Byung-Mo
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Abstract
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Objective: To investigate changes of swallowing function after ballooning dilatation (BD) and the Botox injection (BI) into the cricopharyngeus muscle in patients with severe dysphagia.
Method: Nine severe dysphagic patients with cricopharyngeal dysfunction (CPD) who underwent BD and/or BI into the cricopharyngeal muscle were retrospectively reviewd. Patients who had severe dysphagia (Functional Oral Intake Scale (FOIS)≤2) after at least 3 months of the conventional swallowing therapy were included by a thorough review of medical records with videofluoroscopic swallowing study (VFSS). Before and after several interventions (BD and/or BI), swallowing function was evaluated using VFSS.
Result: Among 9 patients, 5 underwent both BD and BI, and the other 4 patients underwent only BD. Four among 9 cases showed that interventions were effective. Of the 5 cases with both BD and BI, 2 cases were effective for treatment of CPD. In all the effective 4 cases, pyriform sinus residue seemed to be related with FOIS. Of those cases, one case had long-term effect (more than 4 months) and the other 3 case had short term effect (less than 4 months).
Conclusion: Interventions were effective in 4 among 9 cases with severe CPD and the therapeutic effect was sustained for more than 4 months. The results suggest that in CPD patients, the BD or BI into UES could be considered in selected patients.
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KEYWORD
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Botulinum toxin, Cricopharyngeal dilation, Cricopharyngeal dysfunction, Deglutition, Deglutition Disorders, Fluoroscopy
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