Botulinum toxin for dysphagia due to cricopharyngeal dysfunction

Moerman, Mieke; Callier, Yves; Dick, Catherine; Vermeersch, Hubert

doi:10.1007/pl00007520

Cited by 23 publications

(13 citation statements)

References 6 publications

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“…To date, 76 patients with cricopharyngeal achalasia treated with Btx-A injection into the cricopharyngeal muscle have been reported using different techniques: percutaneous (guided by electromyography, computed tomography or videofluoroscopy), direct injection during oesophagoscopy (rigid or flexible) or other endoscopic techniques. [26][27][28][29][30][31][32][33][34][35][36][37][38][39] The results of the 14 studies present in the literature are reported in Table 1. The average success rate was 76% and no major side-effects were reported.…”

Section: Cricopharyngeal Achalasiamentioning

confidence: 99%

Botulinum toxin in the therapy of gastrointestinal motility disorders

Gui

Rossi

Runfola

et al. 2003

Aliment Pharmacol Ther

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Summary Since 1980, botulinum toxin has been employed for the treatment of various voluntary muscle spastic disorders in the fields of neurology and ophthalmology. More recently, botulinum toxin has been proved to be effective in the therapy of dyskinetic smooth muscle disorders of the gastrointestinal tract. Achalasia and anal fissure are the gastrointestinal disorders in which botulinum toxin therapy has been most extensively investigated. Botulinum toxin is the best treatment option for achalasia in patients whose condition makes them unfit for pneumatic dilation or surgery. In anal fissure, botulinum toxin is highly effective and may become the treatment of choice. In the future, botulinum toxin application in the gastrointestinal tract will be extended to many other gastrointestinal disorders, such as non‐achalasic motor disorders of the oesophagus, dysfunction of Oddi's sphincter, achalasia of the internal anal sphincter and others. This article describes the mechanism of action, rationale of employment, indications and side‐effects of botulinum toxin application in smooth muscle disorders of the gastrointestinal tract, and compares the results of different techniques of botulinum toxin therapeutic application.

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Section: Cricopharyngeal Achalasiamentioning

confidence: 99%

Botulinum toxin in the therapy of gastrointestinal motility disorders

Gui

Rossi

Runfola

et al. 2003

Aliment Pharmacol Ther

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“…Tradicionalmente, a miotomia cirúrgica do músculo cricofaríngeo é o tratamento de escolha para hiperatividade do esfíncter esofágico superior. Contudo, é preciso ressaltar, a miotomia do cricofaríngeo é um método invasivo e, segundo alguns autores, nem sempre efetivo (11,(31)(32) .…”

Section: Discussionunclassified

“…A Toxina Botulínica tipo A (Botulim toxin type A -BtxA) foi introduzida para pacientes com espasticidade, hipertonia ou demora na diminuição da tensão do esfíncter esofágico superior. Ocorrem melhoras, mas é necessária a re-injeção em 3-5 meses (11,22,(29)(30)(31)(32) . O procedimento ainda não se verifica como alternativa da miotomia.…”

Section: Revisão Da Literaturaunclassified

A miotomia do cricofaríngeo: artigo de revisão

Amaral¹,

Furkim

2007

Rev. soc. bras. fonoaudiol.

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A miotomia do cricofaríngeo é um procedimento cirúrgico que pode ser indicado para pacientes com disfagia orofaríngea que, em geral, caracterize-se por distúrbio motor limitado à fase faríngea da deglutição, incoordenação cricofaríngea ou relaxamento incompleto do Esfíncter Esofágico Superior (EES). A indicação da miotomia, porém, tem sido discutida e aplicada em muitos casos, sem efeito na melhora da dinâmica da deglutição. O objetivo deste estudo foi verificar os critérios de indicação e eficácia da miotomia do cricofaríngeo, com base nos estudos da fisiologia da deglutição em pacientes com disfagia orofaríngea. Realizou-se, então, uma revisão da literatura sobre este procedimento e a descrição de seus resultados na dinâmica da deglutição. Os resultados demonstraram que os melhores indicadores para uma miotomia bem sucedida são: fase oral eficiente e boa elevação laríngea durante a deglutição. Assim, para uma adequada indicação da miotomia do cricofaríngeo, não se deve avaliar apenas a fase faríngea e o funcionamento isolado do EES, mas a coordenação e relação entre as fases oral e faríngea da deglutição.

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“…In case where muscle weakness at the level of the upper third of the esophagus leads to dysphagia, regurgitation or aspiration, dietary changes and swallowing training may be employed. In selected cases, cricopharyngeal myotomy and botulinum toxin application may be necessary (B) [9] (C) [11,12]. In more severe patients a nasogastric tube or gastrostomy feeding may be recommended to reduce the risk of aspiration and pneumonia (C) [13] (D) [9].…”

Section: Recommendationsmentioning

confidence: 99%

Guidelines of the Brazilian Society of Rheumatology for the treatment of systemic autoimmune myopathies

et al. 2019

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Background: Recommendations of the Myopathy Committee of the Brazilian Society of Rheumatology for the management and therapy of systemic autoimmune myopathies (SAM). Main body: The review of the literature was done in the search for the Medline (PubMed), Embase and Cochrane databases including studies published until June 2018. The Prisma was used for the systematic review and the articles were evaluated according to the levels of Oxford evidence. Ten recommendations were developed addressing the management and therapy of systemic autoimmune myopathies. Conclusions: Robust data to guide the therapeutic process are scarce. Although not proven effective in controlled clinical trials, glucocorticoid represents first-line drugs in the treatment of SAM. Intravenous immunoglobulin is considered in induction for refractory cases of SAM or when immunosuppressive drugs are contra-indicated. Consideration should be given to the early introduction of immunosuppressive drugs. There is no specific period determined for the suspension of glucocorticoid and immunosuppressive drugs when individually evaluating patients with SAM. A key component for treatment in an early rehabilitation program is the inclusion of strengthbuilding and aerobic exercises, in addition to a rigorous evaluation of these activities for remission of disease and the education of the patient and his/her caregivers.

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Botulinum toxin for dysphagia due to cricopharyngeal dysfunction

Cited by 23 publications

References 6 publications

Botulinum toxin in the therapy of gastrointestinal motility disorders

Botulinum toxin in the therapy of gastrointestinal motility disorders

A miotomia do cricofaríngeo: artigo de revisão

Guidelines of the Brazilian Society of Rheumatology for the treatment of systemic autoimmune myopathies

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