Determining the Efficacy of the Chin-Down Maneuver Following Esophagectomy With Fiberoptic Endoscopic Evaluation of Swallowing

Kumai, Yoshihiko; Miyamoto, Takumi; Matsubara, Keigo; Samejima, Yasuhiro; Yoshida, Naoya; Baba, Hideo; Orita, Yorihisa

doi:10.1016/j.apmr.2018.10.007

Cited by 13 publications

(18 citation statements)

References 21 publications

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“…In esophagectomy, the most general gastric reconstruction is gastric conduit [ 9 ]. Cervical anastomosis and paralysis of the recurrent laryngeal nerve sometimes cause pharyngeal swallowing dysfunction and aspiration pneumonia [ 3 , 4 ]. Vocal fold immobility due to injury to the recurrent nerve during esophagectomy causes penetrated materials to be easily aspirated to the trachea [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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Cricopharyngeal myotomy for cricopharyngeus muscle dysfunction after esophagectomy

et al. 2020

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Background: Pharyngoesophageal dysphagia sometimes develops after esophagectomy. However, severe dysphagia after esophagectomy due to cricopharyngeus muscle dysfunction is a rare complication. There are no recommended clinical treatments for cricopharyngeus muscle dysfunction after esophagectomy. We report a case of myotomy for cricopharyngeus muscle dysfunction after esophagectomy. Case presentation: A 75-year-old man with mild dysphagia diagnosed with advanced esophageal cancer by esophagogastroduodenoscopy at a clinic was admitted to our hospital. He had occasional mild dysphagia when he swallowed solid foods. After chemotherapy, the patient underwent minimally invasive esophagectomy with regional lymph node dissection and was reconstructed with a gastric conduit and cervical anastomosis by the retrosternal route. Aspiration pneumonia developed after esophagectomy without paralysis of the vocal cords. In esophagoscopy, there was no stricture around the anastomosis. However, severe pharyngoesophageal dysphagia with cricopharyngeus muscle dysfunction was revealed by videofluoroscopic examination. Bilateral cricopharyngeal myotomy was performed because balloon dilations had failed. The histological findings revealed atrophy and fibrosis of the cricopharyngeus muscle fibers. Pharyngoesophageal dysphagia improved immediately after myotomy. The patient swallowed solid food easily without dysphagia 12 months after myotomy. Conclusion: Dysphagia after esophagectomy was worsened by cricopharyngeus muscle dysfunction. Cricopharyngeus myotomy may lead to long improvement of pharyngo-oesophageal dysphagia after esophagetomy.

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Section: Discussionmentioning

confidence: 99%

“…Dysphagia is a common predominant symptom after esophagectomy [1][2][3][4]. Cervical anastomosis and paralysis of recurrent laryngeal nerve sometimes cause pharyngeal swallowing dysfunction and aspiration pneumonia [5,6].…”

Section: Introductionmentioning

confidence: 99%

Cricopharyngeal myotomy for cricopharyngeus muscle dysfunction after esophagectomy

et al. 2020

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“…Each assessment was performed three times, with the worst score of the three measurements being used for the analysis. The 3-mL volume of contrast substance was considered to be sufficient for detection of aspiration, as reported previously [28,29], and most importantly, it allowed us to reduce the risk of aspiration. The findings were rated using the PAS developed by Rosenbek et al [30].…”

Section: Videofluorographic Swallowing Studymentioning

confidence: 91%

Analysis of Dysphagia and Cough Strength in Patients with Unilateral Vocal Fold Paralysis

et al. 2021

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The association between swallowing function and cough strength in patients with unilateral vocal fold paralysis (UVFP) is unknown. We evaluated the relationship between voluntary cough strength and dysphagia among patients with UVFP (UVFP group) by comparing their data with that of corresponding healthy participants (healthy control [HC] group) in a prospective observational study. From February 1st, 2018 to March 30th, 2019, we recruited patients with a voice disorder due to UVFP, who were referred to our university hospital. Patients with a history of laryngeal surgery, vagal nerve paralysis, or cardiac and respiratory failure were excluded. Descriptive and clinical data regarding swallowing, voice, and cough peak flow (CPF) were collected as a measure of cough strength. The UVFP group comprised six women and seven men (median age, 68.0 years), and the HC group comprised six women and eight men (median age 65.5 years). The groups differed significantly in the Eating Assessment Tool (EAT)-10 scores and CPF rates (P < 0.001). Among patients with UVFP, 84.6% had an abnormal EAT-10 score of ≥ 3. Additionally, 16.7% of the patients exhibited liquid aspiration with contrast medium on a videofluorographic swallowing study (VFSS). There was no correlation between the CPF values, EAT-10 scores, or the VFSS results. Therefore, patients with severe UVFP, whose condition had been fixed, had difficulties when swallowing (85% of cases), and some even presented with aspiration on VFSS (20% of cases), while receiving a regular diet.

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“…The Hyodo score is widely used in clinical practice and studies in Japan. [13][14][15][16] Such objective criteria may be useful in generating reproducible evidence regarding the efficacy of the intervention performed to improve the swallowing function.…”

Section: Introductionmentioning

confidence: 99%

The effect of laryngeal elevation training on swallowing function in patients with dysphagia

et al. 2021

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Objective To investigate the effect of laryngeal elevation training without highly loaded head lifting on swallowing function in patients with dysphagia. Methods Fifty-seven patients with dysphagia (36 men; mean age, 78.5 ± 11.4 years) were included. All participants performed the swallowing forehead exercise and the chin push–pull manoeuvre for two months. Videoendoscopy to assess swallowing function, the peak expiratory flow test and the hand grip strength test were performed at the initial visit (time 1) and two months after the start of the intervention (time 2). We used the Hyodo score, a scoring method for videoendoscopic assessment, for evaluation of swallowing function. Results The linear mixed model showed a significant main effect of time (the Hyodo score at time 1 was greater than the score at time 2). The effects of the co-variates were not significant. Conclusion The present study demonstrated the significant effect of laryngeal elevation training without head lifting on the Hyodo score.

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Determining the Efficacy of the Chin-Down Maneuver Following Esophagectomy With Fiberoptic Endoscopic Evaluation of Swallowing

Cited by 13 publications

References 21 publications

Cricopharyngeal myotomy for cricopharyngeus muscle dysfunction after esophagectomy

Cricopharyngeal myotomy for cricopharyngeus muscle dysfunction after esophagectomy

Analysis of Dysphagia and Cough Strength in Patients with Unilateral Vocal Fold Paralysis

The effect of laryngeal elevation training on swallowing function in patients with dysphagia

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