Botulinum Toxin A Injection Using Esophageal Balloon Radiography Combined with CT Guidance for the Treatment of Cricopharyngeal Dysphagia

Huai, Juan; Hou, Yingkun; Guan, Jiawen; Zhang, Yang; Wang, Yonghui; Zhang, Xiuying; Zhang, Yanyan; Yue, Shouwei

doi:10.1007/s00455-019-10070-5

Cited by 14 publications

(11 citation statements)

References 23 publications

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“…A previous study has demonstrated that a final EAT-10 score of ≥ 3 is considered abnormal [14]. In our study, the mean EAT-10 score at time of treatment termination in the Exp group (3) was significantly lower than that in the Con group (5). From these results, we can conclude that not all participants had an EAT-10 score of < 2 when the intervention was terminated.…”

Section: Table 2 Effects and Complication Measurements Between Groupssupporting

confidence: 46%

“…Cricopharyngeus achalasia is a common cause of dysphagia caused by failure of relaxation of the cricopharyngeus muscle during the pharyngeal phase of swallowing [1][2][3]. Its clinical symptoms and complications include dysphagia, coughing, choking, nasopharyngeal regurgitation, aspiration pneumonia, weight loss, and malnutrition [4,5]. Cricopharyngeus dysfunction (CPD) can be a consequence of a spectrum of neurological diseases, including stroke, multiple sclerosis, amyotrophic lateral sclerosis, primary muscle disorders, skull base neoplasia, and Parkinson's disease [3].…”

Section: Introductionmentioning

confidence: 99%

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A Novel Balloon Catheter-based Dilation Intervention for Patients with Cricopharyngeus Achalasia After Stroke: A Randomized Study

Cai

Shen³

et al. 2022

Dysphagia

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This study aimed to investigate the efficacy and safety of a novel balloon catheter in dilation intervention for patients with cricopharyngeus achalasia after stroke. Thirty-four patients with cricopharyngeus achalasia after stroke received routine swallowing rehabilitation training and were randomly assigned to an experimental group (Exp, n = 17) that received dilation therapy using the novel balloon catheter once daily for 5 days per week or a control group (Con, n = 17) that received dilation therapy with a 14-Fr ordinary urinary catheter once daily for 5 days per week. The intervention duration, Eating Assessment Tool (EAT)-10 scores, and Functional Oral Intake Scale (FOIS) scores were recorded at baseline and each day during intervention. The time for a patient’s FOIS score to be ≥ 3 as well as the recovery time for oral intake of water, liquid food, mushy food, and solid food were recorded or estimated. Complications were also recorded during intervention. The intervention duration was shorter in the Exp group than in the Con group (p = 0.005). The Exp group patients improved faster than the Con group patients, with a shorter recovery time for oral intake of liquid food (p = 0.002), mushy food (p = 0.001), and solid food (p = 0.001). At the time of intervention termination, EAT-10 scores were lower in the Exp group than in the Con group (p = 0.005). The Exp group had a similar incidence of complications as the Con group but with better tolerability (p = 0.028). Compared with the urinary catheter, the novel balloon catheter for dilation in patients with cricopharyngeus achalasia after stroke may lead to a better and more rapid recovery.

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Section: Table 2 Effects and Complication Measurements Between Groupssupporting

confidence: 46%

Section: Introductionmentioning

confidence: 99%

A Novel Balloon Catheter-based Dilation Intervention for Patients with Cricopharyngeus Achalasia After Stroke: A Randomized Study

Cai

Shen³

et al. 2022

Dysphagia

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“…This also be used in ordinary clinical practice as one of the discharge criteria for patients with dysphagia. According to the article from Huai, et al, the clinical outcome of dysphagia patients was considered to be signi cantly improved when FOIS score up to 3 or more 5 . In this study, the recovery time for FOIS score ≥ 3 in experimental group was shorter than control group indicated that the clinical outcome improved quicker when patients received new type balloon catheter dilatation.…”

Section: Discussionmentioning

confidence: 99%

“…Cricopharyngeus achalasia is one of the common cause of dysphagia due to the failure of relaxation of the cricopharyngeus muscle during the pharyngeal phase of swallowing [1][2][3] . Clinical symptoms and complications include dysphagia, coughing, choking, nasopharyngeal regurgitation, aspiration pneumonia, weight loss, and malnutrition 4,5 . Cricopharyngeus achalasia is responsible for a spectrum of neurological diseases, including stroke, multiple sclerosis, amyotrophic lateral sclerosis, primary muscle disorders, skull base neoplasia, and Parkinson's disease 3 , especially the stroke.…”

Section: Introductionmentioning

confidence: 99%

A New Type of Balloon Catheter-Based Dilatation Intervention for Patients With Cricopharyngeus Achalasia After Stroke: A Randomized Study

Cai

Shen

et al. 2021

Preprint

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Purpose To investigated the efficacy and safety of a new type of balloon catheter in dilatation intervention for patients with cricopharyngeus achalasia after stroke. Methods Fifty-two patients with cricopharyngeus achalasia after stroke received routinely swallowing rehabilitation trainings and were randomly assigned to: an experimental group (n = 26) that received dilatation therapy using this new balloon catheter one time per day for 5 days per week and a control group (n = 26) that received dilatation therapy with NO.14 ordinary urinary catheter one time per day for 5 days per week. Duration of intervention, EAT-10 and FOIS scores were recorded at baseline and every day during intervention. The time for FOIS score ≥ 3, the time for recovery of oral intake of water, liquid food, mushy food and solid food were recorded and estimated. Complications were recorded during intervention. Results The Exp group had shorter duration of intervention compared to the Con group (p < 0.001). Exp group improved faster than Con group with shorter recovery time for oral intake of liquid food (p < 0.001), mushy food (p = 0.001) and solid food (p < 0.001). At the termination of intervention, EAT-10 score was lower in Exp group than in Con group (p = 0.002). Compared to the Con group, Exp group had similar incidence of complications but better tolerability (p = 0.006). Conclusion Using this new balloon catheter for dilatation improves more and faster than using ordinary urinary catheter in patients with cricopharyngeus achalasia after stroke.

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“…Later, investigators attempted injecting BTX percutaneously, under the guidance of electromyography (EMG) or endoscope [16,18,21,22]. Some researchers have injected BTX with the guidance of computed tomography (CT), which was shown to be effective and safe [23]. However, each guiding techniques has disadvantages if used alone.…”

Section: Introductionmentioning

confidence: 99%

Design and implementation of botulinum toxin on cricopharyngeal dysfunction guided by a combination of catheter balloon, ultrasound, and electromyography (BECURE) in patients with stroke: study protocol for a randomized, double-blinded, placebo-controlled trial

Xie

Dou

Wan

et al. 2021

Trials

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Background Cricopharyngeal dysfunction (CPD) occurs in various neurological disorders, especially stroke. The treatment approaches of CPD include swallowing training, cricopharyngeal dilation, botulinum toxin (BTX) injection, and cricopharyngeal myotomy. BTX injection into the cricopharyngeal muscle is effective and safe for some patients with dysphagia, with a success rate between 43 and 100% (mean = 76%). However, well-designed randomized controlled clinical trials are needed to verify its efficacy and safety for the treatment of CPD. The objective of this study is to explore the efficacy and safety of BTX for neurogenic cricopharyngeal achalasia, when administering an injection into the cricopharyngeal muscle guided by a novel precise positioning method, that combines ultrasound, catheter balloon, and electromyography (BECURE). Methods BECURE is a single-center randomized, placebo controlled, double-blinded, superiority clinical trial. To detect a significant difference between the 2 groups, a sample size of 44 patients is estimated. The intervention is BTX versus placebo, with 1:1 randomization. The randomization sequence from 1 to 44 was generated using the Statistical Package for Social Sciences. The study is divided into two phases. In the first phase, patients will be injected with BTX or the placebo. In the second phase, patients who received a placebo injection and those who did not respond to the first BTX injection will receive an injection of BTX. The primary outcome is the score of the Functional Oral Intake Scale (FOIS). The secondary outcomes are as follows: upper esophageal sphincter (UES) residual pressure, UES resting pressure, duration of UES relaxation, velopharyngeal and laryngopharyngeal peak pressure, UES opening, pharyngeal construction ratio, residue of bolus in the epiglottis valley or piriform sinus, and penetration and aspiration. Discussion Dysphagia is a common complication of stroke. There is lack of high-quality evidence for the efficacy of BTX in treating neurogenic CPD. This study will clarify whether BTX injection into the cricopharyngeal muscle can be effective and safe for patients with stroke and CPD. Trial registration Chinese Clinical Trial Register (ChiCTR1900025562). Registered on September 1, 2019.

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Botulinum Toxin A Injection Using Esophageal Balloon Radiography Combined with CT Guidance for the Treatment of Cricopharyngeal Dysphagia

Cited by 14 publications

References 23 publications

A Novel Balloon Catheter-based Dilation Intervention for Patients with Cricopharyngeus Achalasia After Stroke: A Randomized Study

A Novel Balloon Catheter-based Dilation Intervention for Patients with Cricopharyngeus Achalasia After Stroke: A Randomized Study

A New Type of Balloon Catheter-Based Dilatation Intervention for Patients With Cricopharyngeus Achalasia After Stroke: A Randomized Study

Design and implementation of botulinum toxin on cricopharyngeal dysfunction guided by a combination of catheter balloon, ultrasound, and electromyography (BECURE) in patients with stroke: study protocol for a randomized, double-blinded, placebo-controlled trial

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