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Otolaryngol Head Neck Surg. 2000 May;122(5):691-5.

Botulinum toxin injection of the cricopharyngeus muscle for the treatment of dysphagia.

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  • 1Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, Michigan, USA.

Abstract

OBJECTIVE:

This study was conducted to evaluate, subjectively and objectively, the diagnostic and therapeutic effects of botulinum toxin (Botox) in patients with dysphagia caused by cricopharyngeus (CP) muscle spasm and/or hypertonicity.

METHODS:

A retrospective chart review was done of 5 patients with normally functioning larynges treated with CP Botox injection for dysphagia caused by perceived spasm. Subjective measures of swallowing function after injection were obtained with a patient questionnaire. Objective data were obtained both before and after surgery by one or more of the following tests: modified barium swallow study, manometry, videostroboscopy, and fiberoptic endoscopic evaluation of swallowing. Quality-of-life measures were obtained with a swallowing rating scale.

RESULTS:

Overall, all patients had initial improvement in swallowing after Botox injection. The duration of benefit was from 2 to 14 months. There were no complications. Four of 5 patients had long-term benefits, as evidenced by decreased or eliminated aspiration symptoms, removal of tracheotomy, ability to eat solid foods, and weight gain. One patient continues to have poor swallowing function.

CONCLUSION:

Botox injection of the CP muscle to treat dysphagia is effective in patients with underlying muscle spasm or hypertonicity. A positive response to Botox can also help confirm the diagnosis of CP muscle spasm.

PMID:
10793348
DOI:
10.1067/mhn.2000.105997
[PubMed - indexed for MEDLINE]
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