Botulinum Toxin Injection for the Treatment of Upper Esophageal Sphincter Dysfunction

Wei, Pengxu

doi:10.3390/toxins14050321

Cited by 12 publications

(12 citation statements)

References 86 publications

(203 reference statements)

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“…It is important to note that botulinum toxin injection should only be administered by specialists who are experienced with this technique and when other simple interventions have been attempted with unsatisfactory results. Side effects, including worsening of reflux and temporary worsening of dysphagia, have been reported ( Wei, 2022 ).…”

Section: Dysphagia In Parkinson’s Diseasementioning

confidence: 99%

Management of dysphagia and gastroparesis in Parkinson’s disease in real-world clinical practice – Balancing pharmacological and non-pharmacological approaches

Bhidayasiri

Phuenpathom

Tan

et al. 2022

Front. Aging Neurosci.

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Gastrointestinal (GI) issues are commonly experienced by patients with Parkinson’s disease (PD). Those that affect the lower GI tract, such as constipation, are the most frequently reported GI problems among patients with PD. Upper GI issues, such as swallowing dysfunction (dysphagia) and delayed gastric emptying (gastroparesis), are also common in PD but are less well recognized by both patients and clinicians and, therefore, often overlooked. These GI issues may also be perceived by the healthcare team as less of a priority than management of PD motor symptoms. However, if left untreated, both dysphagia and gastroparesis can have a significant impact on the quality of life of patients with PD and on the effectiveness on oral PD medications, with negative consequences for motor control. Holistic management of PD should therefore include timely and effective management of upper GI issues by utilizing both non-pharmacological and pharmacological approaches. This dual approach is key as many pharmacological strategies have limited efficacy in this setting, so non-pharmacological approaches are often the best option. Although a multidisciplinary approach to the management of GI issues in PD is ideal, resource constraints may mean this is not always feasible. In ‘real-world’ practice, neurologists and PD care teams often need to make initial assessments and treatment or referral recommendations for their patients with PD who are experiencing these problems. To provide guidance in these cases, this article reviews the published evidence for diagnostic and therapeutic management of dysphagia and gastroparesis, including recommendations for timely and appropriate referral to GI specialists when needed and guidance on the development of an effective management plan.

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Section: Dysphagia In Parkinson’s Diseasementioning

confidence: 99%

Management of dysphagia and gastroparesis in Parkinson’s disease in real-world clinical practice – Balancing pharmacological and non-pharmacological approaches

Bhidayasiri

Phuenpathom

Tan

et al. 2022

Front. Aging Neurosci.

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“…& ]. Different techniques can be used to guide botulinum toxin injection, such as transcutaneous EMG, endoluminal injection under endoscope guidance, as well as ultrasound-guided transcutaneous injection and computed tomography [113 ]. Serious complications, including pharyngocutaneous fistulas, mediastinitis, and perforation of the esophagus have also been rarely reported [113 & ].…”

Section: Acupuncturementioning

confidence: 99%

“…Reduced or absent opening of the UES can represent a pivotal pathophysiological mechanism of dysphagia in patients with stroke and Parkinson's disease [54,55,56 ▪▪ ,112,113 ▪ ,114]. In such cases, botulinum toxin injection into the cricopharyngeal muscle (the main component of the UES) can markedly improve the safety and efficacy of swallowing [55,113 ▪ ].…”

Section: Treatment Strategiesmentioning

confidence: 99%

“…These latter are due to the diffusion of the toxin to nearby muscles, that is, hypopharynx and laryngeal muscles, respectively [55,113 ▪ ]. Serious complications, including pharyngocutaneous fistulas, mediastinitis, and perforation of the esophagus have also been rarely reported [113 ▪ ]. Thus, this off-label treatment should be performed after careful patient selection and discussion with the patient.…”

Section: Treatment Strategiesmentioning

confidence: 99%

“…Different techniques can be used to guide botulinum toxin injection, such as transcutaneous EMG, endoluminal injection under endoscope guidance, as well as ultrasound-guided transcutaneous injection and computed tomography [113 ▪ ].…”

Section: Treatment Strategiesmentioning

confidence: 99%

See 2 more Smart Citations

Assessment and treatment of neurogenic dysphagia in stroke and Parkinson's disease

Cosentino

Todisco

Giudice

et al. 2022

Current Opinion in Neurology

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Purpose of reviewNeurogenic dysphagia worsens quality of life and prognosis of patients with different neurological disorders. Management of neurogenic dysphagia can be challenging. This review provides a comprehensive overview of current evidence on screening, diagnosis, and treatment of neurogenic dysphagia in stroke and Parkinson's disease, suggesting clues for clinical practice.Recent findingsThe pros and cons of diagnostic techniques are discussed in the light of updated evidence. Findings from recent meta-analyses of different treatment approaches, including traditional dysphagia therapy, peripheral and central neurostimulation techniques, and treatment with botulinum toxin, are critically discussed, emphasizing inconsistencies and controversial issues.SummaryScreening tests and clinical swallow examination should be routinely performed in neurological patients at risk for dysphagia. In patients testing positive for dysphagia, first-line instrumental investigations, represented by fiberoptic endoscopic evaluation of swallowing or videofluoroscopic swallow study, should be performed to confirm the presence of dysphagia, to assess its severity, and to inform the treatment. Second-line and third-line instrumental methods can be used in selected patients to clarify specific pathophysiological aspects of oropharyngeal dysphagia. Treatment strategies should be personalized, and combination of traditional dysphagia therapy with innovative treatment approaches may increase the chance of restoring effective and safe swallowing.

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Drugs in focus: Botulinum toxin in the therapy of gastrointestinal disorders in children

Homan,

Thomson,

Bontems

et al. 2024

J. pediatr. gastroenterol. nutr.

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What is Known Botulinum toxin (BoNT) causes muscle relaxation by inhibiting acetylcholine release from presynaptic motor neurons at the neuromuscular junction.What is New In children with achalasia, BoNT can be considered only in patients in whom rapid weight gain is important to improve surgical outcomes. BoNT has been suggested for treating cricopharyngeal achalasia and delayed gastric emptying. Anal achalasia and constipation after Hirschsprung disease corrective surgery are very promising indications for BoNT use. In selected children with resistant type of functional constipation and chronic anal fissure, BoNT is a viable option for treating.

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Botulinum Toxin Injection for the Treatment of Upper Esophageal Sphincter Dysfunction

Cited by 12 publications

References 86 publications

Management of dysphagia and gastroparesis in Parkinson’s disease in real-world clinical practice – Balancing pharmacological and non-pharmacological approaches

Management of dysphagia and gastroparesis in Parkinson’s disease in real-world clinical practice – Balancing pharmacological and non-pharmacological approaches

Assessment and treatment of neurogenic dysphagia in stroke and Parkinson's disease

Drugs in focus: Botulinum toxin in the therapy of gastrointestinal disorders in children

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