The Swallow Physiology Change of Balloon Dilatation on Pharyngeal Dysphagia

Abstract

ObjectiveTo evaluate the effect of balloon dilatation in treating pyriform sinus residue caused by various swallow physiology changes from different medical diagnoses. Study designMedical records of 12 in-patients with moderate to severe pyriform sinus residue were retrospectively reviewed. MethodsAll patients were examined with fiberoptic endoscopic evaluation of swallowing and video fluoroscopic swallowing assessment. The diagnoses of the 12 patients included infarction, nasopharyngeal carcinoma post-radiation, oral cancer post partial glossectomy, and motor neuron disease. All 12 patients underwent balloon dilatation.Each session lasted 30 minutes, with eight dilatations per session, three sessions per week for two weeks. ResultsThere was significant reduction in pharyngeal residue pre-versus post-balloon dilatation (p=0.002). There were also significant improvements in cricopharyngeal muscle achalasia (p=0.004) and weak pharyngeal contraction (p=0.008) pre-versus post-treatment. Eight out of the 12 patients made significant progress toward oral feeding (66.67%). ConclusionOur study found cricopharyngeal muscle achalasia and weak pharyngeal contraction were closely related to pyriform sinus residue in pharyngeal dysphagia. Balloon dilatation eliminated cricopharyngeal muscle achalasia and weak pharyngeal contraction and significantly reduced pyriform sinus residue in 8 of the 12 patients. Balloon dilatation seems to have no effect on the reduction of pyriform sinus residue when the cause was either from discoordination of swallowing subsystems in the case of infarction of the left pontocerebellar trigone or loss of large bulk of tongue tissue in the case of cancer treatment.