Botulinum toxin for upper oesophageal sphincter dysfunction in neurological swallowing disorders

Regan, Julie; Murphy, Anne; Chiang, Mindy; McMahon, Barry P.; Coughlan, Tara; Walshe, Margaret

doi:10.1002/14651858.cd009968.pub2

Cited by 25 publications

(19 citation statements)

References 53 publications

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“…We retrieved the full texts of these reviews, and all review authors performed the final selection. Of these, we excluded two reviews: one review did not provide specific targeted rehabilitation intervention (Mills 2007), and another did not provide any data for the MS population (Regan 2014). Four reviews were still in the protocol stage (Amatya 2017…”

Section: R E S U L T Smentioning

confidence: 99%

Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews

Amatya

Khan

Galea

2019

Cochrane Database of Systematic Reviews

140

124

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Section: R E S U L T Smentioning

confidence: 99%

Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews

Amatya

Khan

Galea

2019

Cochrane Database of Systematic Reviews

140

124

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“…Although reported response rates range from 43% to 100%, 12 a recent Cochrane review determined that there was insufficient evidence for its use to inform clinical practice. 13 In our review, botulinum toxin was used most often in studies of patients with CP achalasia after a cerebrovascular event.…”

Section: Discussionmentioning

confidence: 99%

Cricopharyngeal Achalasia: Management and Associated Outcomes—A Scoping Review

Dewan

Maria

Noel

2020

Otolaryngol.--head neck surg.

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Objective There is little consensus regarding the efficacy and safety of treatment options for cricopharyngeal (CP) achalasia. The purpose of this scoping review is to assess the literature regarding the various treatments for this disease. Data Sources PubMed was searched for all articles addressing treatment of adult CP achalasia between January 1990 and June 2019. Review Methods In total, 351 peer-reviewed results were reviewed by 3 otolaryngologists for inclusion. After review of titles, abstracts, and full texts, 60 articles were selected. Results Among included studies, 55% were retrospective and 45% were prospective. Forty-five percent of studies were case series. CP achalasia etiologies included idiopathic (28%), cerebrovascular accident (CVA) (28%), neurologic disease (17%), head and neck radiation treatment (11%), Zenker’s diverticulum (10%), and myositis (5%). Most commonly employed treatments were botulinum toxin injection (40%), endoscopic CP myotomy (30%), dilation with either balloon or bougie (25%), and open CP myotomy (15%). A proportion of patients were treated with more than 1 approach. Most studies included both subjective and objective outcome measures. Complications were reported most often in patients with a history of head and neck radiation. Conclusions Small sample sizes and heterogeneity of causes and treatments of CP achalasia, as well as short duration of follow-up, make it challenging to assess the superiority of one treatment over another. There is a need for a prospective study that more directly compares outcomes of administration of botulinum toxin, dilation, and CP myotomy in patients with CP achalasia of similar etiologies.

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“…Botulinum toxin response rates have been reported ranging from 43% to 100%. However, a Cochrane review has determined that there is insufficient evidence to support the use of botulinum toxin for UES achalasia 56 . A retrospective review of 49 patients with UES dysfunction treated with botulinum toxin showed symptomatic improvement in 65% of patients.…”

Section: Managementmentioning

confidence: 99%

Aspects of the assessment and management of pharyngoesophageal dysphagia

Allen

Dewan

Herbert

et al. 2020

Annals of the New York Academy of Sciences

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Swallowing complaints are common and may have significant consequences for nutrition and pulmonary health. Etiology varies and different aspects of the deglutitive system may be affected. A thorough assessment from the oral cavity to the stomach will provide physiologic information that enables specific targeted management plans to be devised. Although the swallow trajectory bridges anatomic areas, there has previously been a tendency to compartmentalize assessment and treatment by arbitrary anatomic boundaries. It is now clear that this approach fails to appreciate the complexity of swallow mechanics and that systems (oral, pharyngeal, esophageal, and pulmonary) are intertwined and codependent. Swallowing specialists from different backgrounds and with complementary skill sets form a multidisciplinary team that can provide insight and address multiple areas of management. With the advent of new tools for instrumental evaluation, such as manometry, targeted rehabilitative strategies can be informed by physiology, increased in precision and breadth, and assessed quantitatively. Surgical approaches have evolved toward endoscopic techniques, and food technology is expanding options in dietary management. The multidisciplinary team is core to managing this varied and often neglected patient population. This review is for clinicians treating swallowing disorders and will explore the selected aspects of the assessment and management of pharyngoesophageal swallowing disorders.

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Botulinum toxin for upper oesophageal sphincter dysfunction in neurological swallowing disorders

Abstract: Botulinum toxin for upper oesophageal sphincter dysfunction in neurological swallowing disorders (Review)

Cited by 25 publications

References 53 publications

Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews

Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews

Cricopharyngeal Achalasia: Management and Associated Outcomes—A Scoping Review

Aspects of the assessment and management of pharyngoesophageal dysphagia

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