Assessment of videofluoroscopic swallow study findings before and after cricopharyngeal myotomy

Allen, Jacqui; Blair, Dora; Miles, Anna

doi:10.1002/hed.24846

Cited by 24 publications

(16 citation statements)

References 18 publications

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“…Although several studies reported the relationship between the EAT-10 score and the presence of OD, only two studies investigated this relationship in HNC patients; of these, neither used FEES to evaluated swallowing. [40][41][42][43][44][45][46][47] Arrese et al enrolled 44 HNC patients and compared the EAT-10 scores with the presence of OD using videofluoroscopie (VFS) examination. 46 OD was determined using the penetration-aspiration scale and the modified barium swallow impairment profile.…”

Section: Discussionmentioning

confidence: 99%

EAT‐10 Scores and Fiberoptic Endoscopic Evaluation of Swallowing in Head and Neck Cancer Patients

et al. 2020

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Objective The purpose of this study was to determine the relationship between patient‐reported symptoms of oropharyngeal dysphagia (OD) using the Eating Assessment Tool (EAT)‐10 and the swallowing function using a standardized fiberoptic endoscopic evaluation of swallowing (FEES) protocol in head and neck cancer (HNC) patients with confirmed OD. Methods Fifty‐seven dysphagic HNC patients completed the EAT‐10 and a FEES. Two blinded clinicians scored the randomized FEES examinations. Exclusion criteria consisted of presenting with a concurrent neurological disease, scoring below 23 on a Mini‐Mental State Examination, being older than 85 years, having undergone a total laryngectomy, and being illiterate or blind. Descriptive statistics, linear regression, sensitivity, specificity, and predictive values were calculated. Results The majority of the dysphagic patients (N = 38; 66.7%) aspirated after swallowing thin liquid consistency. A large number of patients showed postswallow pharyngeal residue while swallowing thick liquid consistency. More specifically, 42 (73.0%) patients presented postswallow vallecular residue, and 39 (67.9%) patients presented postswallow pyriform sinus residue. All dysphagic patients had an EAT‐10 score ≥ 3. Linear regression analyses showed significant differences in mean EAT‐10 scores between the dichotomized categories (abnormal vs. normal) of postswallow vallecular (P = .037) and pyriform sinus residue (P = .013). No statistically significant difference in mean EAT‐10 scores between the dichotomized categories of penetration or aspiration was found (P = .966). Conclusion The EAT‐10 questionnaire seems to have an indicative value for the presence of postswallow pharyngeal residue in dysphagic HNC patients, and a value of 19 points turned out to be useful as a cutoff point for the presence of pharyngeal residue in this study population. Level of Evidence: 2b

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Section: Discussionmentioning

confidence: 99%

EAT‐10 Scores and Fiberoptic Endoscopic Evaluation of Swallowing in Head and Neck Cancer Patients

et al. 2020

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“…19 Patients are placed in a lateral decubitus position, and the operation is performed under conscious sedation or narcosis, freehand, or using various devices (e.g., needle-knife, hook-knife, monopolar forceps). 5,20 This type of procedure is particularly indicated for patients unsuitable for general anesthesia due to comorbidities or for patients who have unfavorable anatomical features or problems concerning the positioning of the Weerda diverticuloscope. Flexible endoscopy for ZD has yet to be standardized, and different cutting techniques can be combined with different accessories depending on physicians' personal experience and preferences.…”

Section: Discussionmentioning

confidence: 99%

“…Flexible endoscopic ZD treatment is feasible as well . Patients are placed in a lateral decubitus position, and the operation is performed under conscious sedation or narcosis, freehand, or using various devices (e.g., needle‐knife, hook‐knife, monopolar forceps) . This type of procedure is particularly indicated for patients unsuitable for general anesthesia due to comorbidities or for patients who have unfavorable anatomical features or problems concerning the positioning of the Weerda diverticuloscope.…”

Section: Discussionmentioning

confidence: 99%

“…For many years, the surgical approach to ZD has involved myotomy of the UES associated with diverticulectomy or diverticulopexy. In the last 25 years, a minimally invasive procedure has been adopted in clinical practice, that is, transoral diverticulostomy and flexible endoscopic septotomy with various devices: needle‐knife, hook‐knife, monopolar forceps, and laser (CO 2 , Gold, YAG) . Transoral diverticulostomy/septotomy was first described by Collard et al in 1993.…”

Section: Introductionmentioning

confidence: 99%

“…In the last 25 years, a minimally invasive procedure has been adopted in clinical practice, that is, transoral diverticulostomy and flexible endoscopic septotomy with various devices: needle-knife, hook-knife, monopolar forceps, and laser (CO 2 , Gold, YAG). 5 Transoral diverticulostomy/septotomy was first described by Collard et al in 1993. The procedure is performed through the Weerda diverticuloscope and, using an endostapler, the anterior wall of the diverticulum and the posterior wall of the esophagus are sealed and divided.…”

Section: Introductionmentioning

confidence: 99%

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Traction on the septum during transoral septotomy for Zenker diverticulum improves the final outcome

et al. 2019

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Objective Transoral diverticulostomy/septotomy has become a popular treatment for patients with Zenker diverticulum (ZD). To improve the results of transoral stapler‐assisted septotomy, a modification of the technique has been introduced. In this study, we aimed to compare the final outcome of such a modified transoral septotomy (MTS) with the results of traditional transoral septotomy (TTS) in patients with ZD. Methods Fifty‐two consecutive patients with ZD underwent transoral stapler‐assisted septotomy between 2010 and 2018. Symptoms were recorded and scored using a detailed questionnaire. Barium swallow, endoscopy, and manometry were performed before and after the procedure. Results Of the 52 patients forming the study population (male:female = 35:17), 25 had TTS and 27 had MTS. The patients’ demographic and clinical parameters were similar in the two groups. No intraoperative mucosal lesions were detected, and the mortality was nil. The median time taken to complete the procedure was 25 minutes (interquartile range [IQR]: 22–35) for TTS, and 30 minutes (IQR: 25–36) for MTS (P < 0.07). The median follow‐up was 69 months (IQR: 46–95) in the TTS group and 30 months (IQR: 25–35) in the MTS group. All patients in both groups had an improvement in their symptom score after the procedure, but the failure rates were 32% (8 of 25) after TTS and 3.7% (1 of 27) after MTS (P < 0.02). At univariate and multivariate analyses, the procedure was the only predictor of a positive final outcome. Conclusion Albeit with the intrinsic limitations of the study (retrospective, different time window, and different follow‐up), traction on the septum during transoral septotomy improves the final outcome of this treatment in patients with ZD. Level of Evidence 4 Laryngoscope, 130:637–640, 2020

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Surgery for Swallowing Disorders

Yang

Postma

2022

Textbook of Surgery of Larynx and Trachea

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Assessment of videofluoroscopic swallow study findings before and after cricopharyngeal myotomy

Cited by 24 publications

References 18 publications

EAT‐10 Scores and Fiberoptic Endoscopic Evaluation of Swallowing in Head and Neck Cancer Patients

EAT‐10 Scores and Fiberoptic Endoscopic Evaluation of Swallowing in Head and Neck Cancer Patients

Traction on the septum during transoral septotomy for Zenker diverticulum improves the final outcome

Surgery for Swallowing Disorders

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