 |
|
Failure of Cricopharyngeal Myotomy to Improve Dysphagia Following Head and Neck Cancer Surgery
John R. Jacobs, MD;
Jerilyn Logemann, PhD;
Thomas F. Pajak, PhD;
Barbara Roa Pauloski, PhD;
Sharon Collins, MD;
Roy R. Casiano, MD;
David E. Schuller, MD
Arch Otolaryngol Head Neck Surg. 1999;125:942-946.
Objective To determine whether cricopharyngeal myotomy can improve dysphagia associated with head and neck cancer surgery.
Design Prospective, randomized, multicenter trial.
Setting Twelve clinical sites across the United States.
Patients Between 1989 and 1994, 125 patients undergoing combined modality therapy for head and neck cancer, including resection of the tongue base or supraglottic larynx, were prospectively entered into the trial.
Intervention Cricopharyngeal myotomy on a randomized basis.
Main Outcome Measures Videofluoroscopic examination to determine oropharyngeal swallowing efficiency, which is defined as the ratio of percentage of the bolus swallowed to total swallowing time using 3 different bolus consistencies.
Results No significant difference in oropharyngeal swallowing efficiency between myotomy vs no myotomy was seen at 6 months of follow-up regardless of bolus consistency.
Conclusions In this prospective test of cricopharyngeal myotomy, the procedure fails to significantly improve dysphagia associated with head and neck cancer surgery. The efficacy of this surgical procedure in other disease entities should also be rigorously explored.
From the Department of Otolaryngology–Head and Neck Surgery, Wayne State University, Detroit, Mich (Dr Jacobs); Department of Communication Sciences and Disorders, Northwestern University, Evanston, Ill (Drs Logemann and Pauloski); Radiation Therapy Oncology Group, American College of Radiology, Philadelphia, Pa (Dr Pajak); Department of Otolaryngology–Head and Neck Surgery, Loyola University, Maywood, Ill (Dr Collins); Department of Otolaryngology–Head and Neck Surgery, University of Miami, Miami, Fla (Dr Casiano); and Department of Otolaryngology–Head and Neck Surgery, Ohio State University, Columbus (Dr Schuller).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Pilot study of a neurophysiological dysphagia therapy for neurological patients
Seidl et al.
Clin Rehabil 2007;21:686-697.
ABSTRACT
The Failure of Cricopharyngeal Myotomy to Improve Postoperative Dysphagia: Is Videofluoroscopic Diagnosis Adequate?
Spiegel et al.
Arch Otolaryngol Head Neck Surg 2000;126:804-804.
FULL TEXT
|
