The Effect of Balloon Dilation at the Vallecular Using Videofluoroscopic Swallowing Study on Patient Who Has a Dysphagia

Abstract

Authors have previously experienced the effect of balloon dilation at the vallecular by utilizing the video-fluoroscopic swallowing study (VFSS) and the urethral catheter to physically stretch and spread in the direction of the posterior inferior towards the patients who have claimed for dysphagia symptoms due to epiglottic dysfunction. A 72-year-old male patient has been diagnosed with rectal cancer and have been treated with an ileocolostomy after the intubation. After the removal of tracheal intubation, the patient complained of dysphagia. Foods and drinks could not be transmigrated into the esophagus due to the inability of the epiglottis to bend backward in the direction of posterior inferior on VFSS. The epiglottis was physically stretched and spread in the direction of posterior inferior by utilizing the balloon attached to a urethral catheter. After stretching and spreading the epiglottis in the direction of posterior inferior, the bolus remaining in the epiglottic vallecula was decreased. For a patient who is experiencing dysphagia due to an epiglottis disorder, it seems that an epiglottis balloon dilation supported by VFSS and a urethral catheter may be appropriate for the treatment of dysphagia symptoms.

Effect of Vallecular Ballooning in Stroke Patients With Dysphagia

“…Our institution had previously reported a case of improvement in the swallowing parameters, including reduction of the vallecular remnant and decrease in pharyngeal transit time, after epiglottis backward stretching through the ballooning procedure with a Foley catheter in the vallecular space in patients with lowered kinetic movement after intubation [ 7 ]. The subject of the previous study was not a patient of neurogenic dysphagia, and did not have disorders in the swallowing parameters, except for deteriorated epiglottis mobility.…”

“…A study by Kim et al [ 7 ] reports the improvement of the swallowing parameters, including reduction of the vallecular remnant and decrease in pharyngeal transit time, after backward stretching of the epiglottis through a ballooning procedure using a Foley catheter at the vallecular space in a patient with deteriorated kinetic movement of the epiglottis after intubation. The unique feature of this paper was that a swallowing improvement effect was obtained by imposing direct passive backward stretching using ballooning to the epiglottis, unlike other previous papers that focused on improving the hyoid bone movement.…”