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Office-based Electromyography-guided Botulinum Toxin Injection to the Cricopharyngeus Muscle: Optimal Patient Selection and Technique.

Abstract This retrospective study was carried out to investigate the effectiveness and safety of office-based electromyography-guided injection of botulinum toxin in the cricopharyngeus muscle of patients who did not show upper esophageal sphincter passage in a swallowing study in spite of maximal swallowing rehabilitation.
PMID
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Authors

Mayor MeshTerms

Deglutition Disorders

Pharyngeal Muscles

Keywords

botulinum toxins type A

deglutition

deglutition disorders

electromyography

upper esophageal sphincter

Journal Title the annals of otology, rhinology, and laryngology
Publication Year Start




PMID- 28397562
OWN - NLM
STAT- MEDLINE
DA  - 20170411
DCOM- 20170418
LR  - 20170418
IS  - 1943-572X (Electronic)
IS  - 0003-4894 (Linking)
VI  - 126
IP  - 5
DP  - 2017 May
TI  - Office-based Electromyography-guided Botulinum Toxin Injection to the
      Cricopharyngeus Muscle: Optimal Patient Selection and Technique.
PG  - 349-356
LID - 10.1177/0003489416689469 [doi]
AB  - OBJECTIVES: This retrospective study was carried out to investigate the
      effectiveness and safety of office-based electromyography-guided injection of
      botulinum toxin in the cricopharyngeus muscle of patients who did not show upper 
      esophageal sphincter passage in a swallowing study in spite of maximal swallowing
      rehabilitation. METHODS: Thirty-six patients who showed no or limited ability to 
      oral feed after maximum swallowing rehabilitation were enrolled. Video
      fluoroscopic swallowing study, flexible endoscopic evaluation of swallowing,
      disability rating scale, penetration aspiration score, and National Institutes of
      Health swallowing safety scale were used in the evaluation of dysphagia. RESULTS:
      Success was defined as nondependence on gastrostomy for patients who previously
      were dependent on gastrostomy and improvement in disability rating scale score
      after botulinum toxin injections. The total success rate was 63.9%. The
      complication rate was very low, with only 1 patient showing temporary unilateral 
      vocal fold paralysis. Botulinum toxin injection was more effective in patients
      with cranial nerve IX or X palsy than in those without it ( P = .006).
      CONCLUSIONS: This procedure can be a simple, safe, and effective tool in patients
      with cricopharyngeal dysfunction after swallowing rehabilitation, especially for 
      cranial nerve IX or X palsy.
FAU - Kim, Min-Su
AU  - Kim MS
AD  - 1 Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan
      Hospital, Gyeonggi-do, Korea.
FAU - Kim, Go-Woon
AU  - Kim GW
AD  - 2 Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial
      Institute of Head and Neck Cancer, Hallym University College of Medicine, Seoul, 
      Korea.
FAU - Rho, Young-Soo
AU  - Rho YS
AD  - 2 Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial
      Institute of Head and Neck Cancer, Hallym University College of Medicine, Seoul, 
      Korea.
FAU - Kwon, Kee-Hwan
AU  - Kwon KH
AD  - 2 Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial
      Institute of Head and Neck Cancer, Hallym University College of Medicine, Seoul, 
      Korea.
FAU - Chung, Eun-Jae
AU  - Chung EJ
AD  - 3 Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National
      University College of Medicine and Seoul National University Hospital, Seoul,
      Korea.
LA  - eng
PT  - Journal Article
DEP - 20170223
PL  - United States
TA  - Ann Otol Rhinol Laryngol
JT  - The Annals of otology, rhinology, and laryngology
JID - 0407300
RN  - 0 (Neuromuscular Agents)
RN  - EC 3.4.24.69 (Botulinum Toxins, Type A)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Botulinum Toxins, Type A/*administration & dosage
MH  - Deglutition/*drug effects
MH  - *Deglutition Disorders/diagnosis/physiopathology/therapy
MH  - Electromyography/*methods
MH  - Esophageal Sphincter, Upper/physiopathology
MH  - Female
MH  - Humans
MH  - Injections, Intramuscular
MH  - Middle Aged
MH  - Neuromuscular Agents/administration & dosage
MH  - Patient Selection
MH  - *Pharyngeal Muscles/diagnostic imaging/physiopathology
MH  - Republic of Korea
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - botulinum toxins type A
OT  - deglutition
OT  - deglutition disorders
OT  - electromyography
OT  - upper esophageal sphincter
EDAT- 2017/04/12 06:00
MHDA- 2017/04/19 06:00
CRDT- 2017/04/12 06:00
AID - 10.1177/0003489416689469 [doi]
PST - ppublish
SO  - Ann Otol Rhinol Laryngol. 2017 May;126(5):349-356. doi: 10.1177/0003489416689469.
      Epub 2017 Feb 23.

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