Targeted use of endoscopic CO2 laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment. Issue 12 (December 2014)

• Record Type: Journal Article
• Authors: Dawe, N; Patterson, J; Hamilton, D; Hartley, C
• Is Part Of: Journal of laryngology & otology. Volume 128:Issue 12(2014)
• Page Start: 1105
• Page End: 1110
• Publication Date: 2014-12
• Subjects: Otolaryngology -- Periodicals; 617.51
• DOI: 10.1017/S0022215114002692
• Languages: English
• ISSNs: 0022-2151

Abstract

<abstract abstract-type="normal"> <title>Abstract</title> <sec id="sec1"> <title>Background:</title> <p>Cricopharyngeal dysfunction following head and neck cancer treatment may lead to a significant reduction in oral intake. Carbon dioxide laser is an established procedure for the treatment of non-malignant cricopharyngeal disorders. We report our experience of laser cricopharyngeal myotomy with objective swallowing outcome measures, before and after treatment.</p> </sec> <sec id="sec2"> <title>Methods:</title> <p>We identified 11 patients who had undergone carbon dioxide laser cricopharyngeal myotomy for dysphagia following radiotherapy, with or without chemotheraphy between January 2006 and July 2011. We analysed the swallowing outcomes following carbon dioxide laser cricopharyngeal myotomy by retrospective grading of pre- and post-procedure videofluoroscopic swallowing study of liquids, using the validated Modified Barium Swallow Impairment Profile.</p> </sec> <sec id="sec3"> <title>Results:</title> <p>The median Modified Barium Swallow Impairment Profile score was 13 pre-myotomy and 10 post-myotomy. This difference between scores was non-significant (<italic>p</italic> = 0.41). The median, cricopharyngeal-specific Modified Barium Swallow Impairment Profile variables (14 and 17) improved from 3 to 2, but were similarly non-significant (<italic>p</italic> = 0.16). We observed the improved Modified Barium Swallow Impairment Profile scores post-procedure in the majority of patients.</p> </sec> <sec id="sec4"> <title>Conclusion:</title> <p>Endoscopic carbon dioxide laser cricopharyngeal myotomy remains a viable option in treatment-related cricopharyngeal dysfunction; its targeted role requires further prospective study. Objective analysis of the technique can be reported using the validated Modified Barium Swallow Impairment Profile.</p> </sec> </abstract>