Paralysis of Deglutition, a Post-Poliomyelitis Complication Treated by Section of the Cricopharyngeus Muscle*

Kaplan, Samuel

doi:10.1097/00000658-195104000-00021

Cited by 146 publications

(30 citation statements)

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“…Kaplan [9] ®rst reported the eect of cricopharyngeal myotomy in the treatment of severe dysphagia in a patient with polymyositis. Since then, myotomy has been described as bene®cial in the management of cricopharyngeal dysphagia of various origins [10].…”

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confidence: 99%

Botulinum Toxin in the Treatment of Cricopharyngeal Dysphagia

et al. 2001

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Dysphagia is a common symptom in various neurological disorders affecting pharyngeal functions. Cricopharyngeal dysfunction is one of the major findings in these patients. The most effective treatment for restoring normal swallowing function in persistent cricopharyngeal dysfunction is cricopharyngeal myotomy, especially when mechanical obstruction or a well-localized neuromuscular dysfunction, such as a cricopharyngeal muscle spasm, is present. However, when there is a more diffuse neurological disorder present the results of surgery are more disappointing. In unclear cases, or in patients with temporary problems, no good method other than swallowing training, bougienage, and tube feeding are available. During the past decade, botulinum toxin has been found to be of therapeutic value in the treatment of a variety of neurological disorders associated with inappropriate muscular contractions such as torticollis and spasmodic dysphonia. Recently, injections of botulinum toxin in patients with cricopharyngeal muscle dysfunction have been reported to result in marked relief of dysphagia. In this article we describe our experiences with botulinum toxin injections to treat four patients suffering from deglutition problems and cricopharyngeal dysphagia of different origins. Botulinum toxin was injected into the cricopharyngeus muscle that was identified by endoscopy under general anesthesia. In this study, no major side effects were observed. Three patients obtained a significant improvement of esophageal symptoms after the first injection. The treatment had limited effect in one patient who had reflux disease and only slight cricopharyngeus dysfunction.

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confidence: 99%

Botulinum Toxin in the Treatment of Cricopharyngeal Dysphagia

et al. 2001

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“…Asherton, in 1950, described the entity of``cricopharyngeal achalasia'' [4]. In 1951, myotomy of the CPM was ®rst attempted by Kaplan in a patient with polio [5]. Other conditions associated with CPM dysfunction include amyotrophic lateral sclerosis, pharyngeal diverticula, cerebrovascular accident (CVA), surgical skull base lesions, laryngectomy, and occulopharyngeal muscular dystrophy.…”

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confidence: 99%

Botulinum Toxin Treatment for Cricopharyngeal Dysfunction

Shaw

Searl

2001

Dysphagia

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Hypertonicity and spasticity of the cricopharyngeal muscle (CPM) often result in dysphagia characterized by difficulty passing a bolus through the upper esophageal sphincter. Past treatments for this problem have included mechanical dilation and endoscopic and transcervical cricopharyngeal myotomy. More recently, botulinum toxin injections into the CPM have been successful, but only in isolated case studies and small series. This study reports pre- and post-botulinum toxin A injection results for 12 subjects, including patient ratings of symptom severity, changes noted during modified barium swallow studies, and, in some cases, manometry of the upper esophageal sphincter. Results indicate that botulinum toxin A treatment provided significant improvement in swallowing as indicated by patient symptom ratings and investigator ratings of function from modified barium swallow studies. Greater improvement was seen in those with more isolated CPM or Xth nerve dysfunction rather than those with more global dysphagia abnormalities.

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“…Gastrostomy is seldom advised. Cricopharyngeal myotomy was first used by Kaplan in 1951' in a patient with bulbar poliomyelitis and has been advocated by Mills"'7 in the United Kingdom, and Lebo et al' in the USA.…”

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Cricopharyngeal myotomy in motor neurone disease.

Loizou¹,

Small²,

Dalton³

1980

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY Twenty-five patients with dysphagia caused by neurological disorders, mainly motor neurone disease, underwent cricopharyngeal myotomy. Nineteen patients showed slight to dramatic improvement of swallowing for variable periods of time. There were five postoperative deaths. The results indicate that this simple procedure is of benefit to a substantial proportion of patients with neurological causes of dysphagia.

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Paralysis of Deglutition, a Post-Poliomyelitis Complication Treated by Section of the Cricopharyngeus Muscle*

Cited by 146 publications

References 1 publication

Botulinum Toxin in the Treatment of Cricopharyngeal Dysphagia

Botulinum Toxin in the Treatment of Cricopharyngeal Dysphagia

Botulinum Toxin Treatment for Cricopharyngeal Dysfunction

Cricopharyngeal myotomy in motor neurone disease.

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