Efficacy of large-diameter dilatation in cricopharyngeal dysfunction

Abstract

In the largest series of esophageal dilatation for cricopharyngeal dysfunction in the literature, we found large-bore bougienage to have significant utility due to its efficacy, ease of use, and safety when compared to other modalities such as botulinum injection, balloon dilatation, and cricopharyngeal myotomy.

Cricopharyngeal dysfunction: A systematic review comparing outcomes of dilatation, botulinum toxin injection, and myotomy

“…Clary et al suggested CP bougie dilatation as a first surgical step. They advocate this two‐step approach for two reasons: 1) if dysphagia resolves, the patient can avoid a more morbid myotomy, and 2) if patient experiences no relief, it can suggest a need for further workup to evaluate other causes of dysphagia …”

“…The range of BoT doses reported per injection varies from 10 U to 100 U . Bougienage has been used in the treatment of anatomic esophageal strictures for decades . The commonly used approaches are bougies, wire‐guided polyvinyl dilators, air‐filled pneumatic dilatation, and water‐filled balloon dilatation with or without endoscopy guidance …”

Videofluoroscopy-Guided Balloon Dilatation for the Opening Dysfunction of Upper Esophageal Sphincter by Postoperative Vagus Nerve Injury: A Report on Two Cases

“…This method has a limitation that it should be performed only by an endoscopy specialist. Clary et al [8] used a larger 60-Fr esophageal dilator. This also needs a laryngoscopist; and patients should undergo sedation or general anesthesia [8].…”

“…Clary et al [8] used a larger 60-Fr esophageal dilator. This also needs a laryngoscopist; and patients should undergo sedation or general anesthesia [8]. Furthermore, minor complications, such as mucosal tear, laryngospasm, and low postprocedural oxygen saturation, were observed in 10% of patients.…”

Savary Dilation is a Safe and Effective Long-term Means of Treatment of Symptomatic Cricopharyngeal Bar

“…3 Once a CP bar becomes symptomatic, it is an important cause of oropharyngeal dysphagia, causing a restrictive defect at the pharyngoesophageal junction. [6][7][8] At our institution, we initially perform Savary dilation for symptomatic CP bars. Dilation of a CP bar can be a safe and effective means of nonsurgical treatment as this patient population has high morbidity and is at a higher risk of surgical complications.…”