Targeted use of endoscopic CO<sub>2</sub> laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment

Dawe, Nick; Patterson, Joanne; Hamilton, David W.; Hartley, Chris

doi:10.1017/s0022215114002692

Cited by 11 publications

(6 citation statements)

References 27 publications

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“…A final total of 14 observational retrospective studies (N = 264 patients) met eligibility criteria and were included in the current systematic review as summarized with the surgical procedure characteristics in Table 1. [11][12][13][14][15][16][17][18][19][20][21][22][23][24] Table 2 shows the preoperative swallowing assesment and success and complication rates of CP myotomy (N = 3 studies; overall 36 patients), UES dilation (N = 10 studies; overall 208 patients), and Botox injection to the CP muscle (N =1 study; 20 patients) in adult HNC patients with dysphagia following organ preservation therapy.…”

Section: Resultsmentioning

confidence: 99%

“…37,11 Our extensive literature review yielded only 3 studies on the effectiveness of CPM for postradiation CP dysfunction or lack of relaxation. 11-13 Overall, only 36 patients were included with mixed success rates. Bergeron and Chhetri 11 compared CPM outcomes based on etiology and indication and found the least improvement for those with prior radiation.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Management of Postradiation Dysphagia in Head and Neck Cancer Patients: A Systematic Review

Abu‐Ghanem

Sung

Junlapan

et al. 2019

Ann Otol Rhinol Laryngol

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Objectives: To systematically review the success rate and safety profile of the available endoscopic surgical options for radiation-induced dysphagia in head and neck cancer patients following organ preservation treatment, including upper esophageal sphincter (UES) dilation, cricopharyngeus (CP) myotomy (CPM), and CP intramuscular botulinum toxin (Botox) injection. Methods: A search of MEDLINE, Scopus, Google Scholar, and Cochrane databases was done to identify articles published between January 1980 and December 2017. Pediatric series, foreign language articles, series with Zenker’s diverticulum or following primary surgical treatment including laryngectomy, open UES/CP surgery, or samples with fewer than 5 patients were excluded. Results: An initial search identified 539 articles. All titles and abstracts were reviewed. One hundred and sixteen potentially relevant articles were inspected in more detail, and 14 retrospective studies met eligibility criteria. Dilation group included 10 studies on anterograde and/or retrograde dilation, with an overall 208 patients. Success rate ranged from 42% to 100%. The endoscopic CPM group included 3 studies with a total of 36 patients, and the success rate ranged from 27% to 90%. In the Botox group, 1 one study with 20 patients met our inclusion criteria, with an overall 65% success rate (13/20). Major complications were only reported in the dilation group, which included esophageal perforation and death. Conclusions: The lack of consistency across trials indicates insufficient evidence for guiding clinical practice. This systematic review suggests the need for greater standardization of outcomes and instruments. Future prospective evaluation should use validated patient-rated and clinician-rated assessment tools to optimally measure postoperative swallowing outcomes of head and neck cancer dysphagic patients following organ preservation therapy.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic Management of Postradiation Dysphagia in Head and Neck Cancer Patients: A Systematic Review

Abu‐Ghanem

Sung

Junlapan

et al. 2019

Ann Otol Rhinol Laryngol

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“…found that endoscopic cricopharyngeal myotomy significantly reduced aspiration in adults with unspecified cricopharyngeal bar disorders. However, Dawe et al 24 . reported that the aspiration of food and laryngeal penetration in adults with an upper oesophageal sphincter (UOS) dysfunction following chemoradiation therapy was not significantly improved with endoscopic cricopharyngeal myotomy, as measured using the Modified Barium Swallow Impairment Profile 26 .…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of endoscopic cricopharyngeal myotomy in adults with neurological disease: systematic review

et al. 2016

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No determinations could be made regarding endoscopic cricopharyngeal myotomy effectiveness in the cohort of interest. Reliable and valid evidence on the following is required to support increasing clinical usage of endoscopic cricopharyngeal myotomy: optimal candidacy selection; standardised post-operative management protocol; complications; and endoscopic cricopharyngeal myotomy effects on aspiration of food and laryngeal penetration, mean upper oesophageal sphincter resting pressure and quality of life.

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“…The elective treatment is radical extirpation with wide and safety margin to reduce local recurrence. [15][16][17] In this patient, due to his elevated cardiac surgical risk and associated vasculopathy, we chose to use a Becker-type cervicopectoral graft irrigated by perforating arteries from the internal mammary artery which not only provided very good circulation but simultaneously reduced the operative time when compared with using a microvascular graft. This musculocutaneous graft proved an adequate size both to cover the maxillary reconstruction prosthesis as well as allowing being performed the lymphadenectomy.…”

Section: Discussionmentioning

confidence: 99%

Malignant Peripheral Nerve Sheath Tumor of the Infraorbital Nerve

D’Addino¹,

Piccoletti²,

Pigni³

et al. 2016

Craniomaxillofacial Trauma & Reconstruction

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The objective of this study is to report a large, rare, and ulcerative infiltrated skin lesion. Its diagnosis, therapeutic management, and progress are described. The patient is a 78-year-old white man, who presented with a 12-month ulcerative perforated lesion that had affected and infiltrated the skin, with easy bleeding. He had a history of hypertension, although controlled, was a 40-year smoker, had chronic atrial fibrillation, diabetes, and microangiopathy. During the consultation, the patient also presented with ocular obstruction due to an inability to open the eye. He mentioned having reduced vision. The computed tomography scan showed upper maxilla osteolysis without eye involvement. We underwent a radical resection in which upper maxilla and the anterior orbital margin were included. We used a Becker-type flap that allowed us to rebuild the cheek and to complete a modified neck dissection. Progress was favorable; the patient recovered ocular motility and his vision improved to 20/200. The final biopsy result was "malignant peripheral nerve sheath tumor, malignant schwannoma." Malignant schwannoma of the peripheral nerve is extremely rare. The total resection and reconstruction being completed in one surgery represented a challenge due to the difficulty in obtaining tissues in addition to the necessity of an oncological resection.

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Targeted use of endoscopic CO₂ laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment

Cited by 11 publications

References 27 publications

Endoscopic Management of Postradiation Dysphagia in Head and Neck Cancer Patients: A Systematic Review

Endoscopic Management of Postradiation Dysphagia in Head and Neck Cancer Patients: A Systematic Review

Effectiveness of endoscopic cricopharyngeal myotomy in adults with neurological disease: systematic review

Malignant Peripheral Nerve Sheath Tumor of the Infraorbital Nerve

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Targeted use of endoscopic CO2 laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment

Cited by 11 publications

References 27 publications

Endoscopic Management of Postradiation Dysphagia in Head and Neck Cancer Patients: A Systematic Review

Endoscopic Management of Postradiation Dysphagia in Head and Neck Cancer Patients: A Systematic Review

Effectiveness of endoscopic cricopharyngeal myotomy in adults with neurological disease: systematic review

Malignant Peripheral Nerve Sheath Tumor of the Infraorbital Nerve

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Product

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Targeted use of endoscopic CO₂ laser cricopharyngeal myotomy for improving swallowing function following head and neck cancer treatment