Skip to main content
Top
Published in: Dysphagia 4/2012

01-12-2012 | Original Article

The Effect of Different Catheter Balloon Dilatation Modes on Cricopharyngeal Dysfunction in Patients with Dysphagia

Authors: Zulin Dou, Yihe Zu, Hongmei Wen, Guifang Wan, Li Jiang, Youhong Hu

Published in: Dysphagia | Issue 4/2012

Login to get access

Abstract

The primary aim of this study was to investigate the outcomes of two different modes (active and passive) of balloon dilatation therapy on cricopharyngeal dysfunction (CPD). Thirty-eight CPD patients with neurological disorders were recruited between 2006 and 2010. Twenty-one of them received active balloon dilatation therapy, and the remaining 17 received passive dilatation therapy for an average of 4 weeks. The patients’ swallowing function before and after the intervention was evaluated using the Functional Oral Intake Scale (FOIS) and the upper esophageal sphincter (UES) opening was studied with the videofluoroscopic swallow study. Both modes of balloon dilatation therapy yielded improvements in the FOIS (active group: z = −3.767, p < 0.001; passive group: z = −3.472, p < 0.001) and the UES opening (both groups: p < 0.01). Active dilatation showed a significantly better FOIS result (p = 0.028) than passive dilatation for CPD. Both active and passive balloon dilatation benefits patients with neurological disorders but active balloon dilatation is better.
Literature
1.
go back to reference Ali GN, Wallace KL, Laundl TM, Hunt DR, Darle DJ, Cook IJ. Predictors of outcome following cricopharyngeal disruption for pharyngeal dysphagia. Dysphagia. 1997;12:133–9.PubMedCrossRef Ali GN, Wallace KL, Laundl TM, Hunt DR, Darle DJ, Cook IJ. Predictors of outcome following cricopharyngeal disruption for pharyngeal dysphagia. Dysphagia. 1997;12:133–9.PubMedCrossRef
2.
go back to reference Lang IM, Shaker R. Anatomy and physiology of the upper esophageal sphincter. Am J Med. 1997;103:50S–5S.PubMedCrossRef Lang IM, Shaker R. Anatomy and physiology of the upper esophageal sphincter. Am J Med. 1997;103:50S–5S.PubMedCrossRef
3.
go back to reference Lang IM, Shaker R. An overview of the upper esophageal sphincter. Curr Gastroenterol Rep. 2000;2:185–90.PubMedCrossRef Lang IM, Shaker R. An overview of the upper esophageal sphincter. Curr Gastroenterol Rep. 2000;2:185–90.PubMedCrossRef
5.
go back to reference Cook IJ. Diagnosis and management of cricopharyngeal achalasia and other upper esophageal sphincter opening disorders. Curr Gastroenterol Rep. 2000;2:191–5.PubMedCrossRef Cook IJ. Diagnosis and management of cricopharyngeal achalasia and other upper esophageal sphincter opening disorders. Curr Gastroenterol Rep. 2000;2:191–5.PubMedCrossRef
6.
go back to reference Cook IJ, Kahrilas PJ. American Gastroenterological Association technical review on management of oropharyngeal dysphagia. Gastroenterology. 1999;116:455–78.PubMedCrossRef Cook IJ, Kahrilas PJ. American Gastroenterological Association technical review on management of oropharyngeal dysphagia. Gastroenterology. 1999;116:455–78.PubMedCrossRef
7.
go back to reference Brooks A, Millar AJW, Rode H. The surgical management of cricopharyngeal achalasia in children. Int J Pediatr Otolaryngol. 2000;56:1–7.CrossRef Brooks A, Millar AJW, Rode H. The surgical management of cricopharyngeal achalasia in children. Int J Pediatr Otolaryngol. 2000;56:1–7.CrossRef
8.
go back to reference Cook IJ, Kahrilas PJ. American Gastroenterological Association medical position statement on management of oropharyngeal dysphagia. Gastroenterology. 1999;116:452–4.CrossRef Cook IJ, Kahrilas PJ. American Gastroenterological Association medical position statement on management of oropharyngeal dysphagia. Gastroenterology. 1999;116:452–4.CrossRef
9.
go back to reference Blitzer A, Brin MF. Use of botulinum toxin for diagnosis and management of cricopharyngeal achalasia. Otolaryngol Head Neck Surg. 1997;116:328–30.PubMedCrossRef Blitzer A, Brin MF. Use of botulinum toxin for diagnosis and management of cricopharyngeal achalasia. Otolaryngol Head Neck Surg. 1997;116:328–30.PubMedCrossRef
11.
go back to reference Wang AY, Kadkade R, Kahrilas PJ, Hirano I. Effectiveness of esophageal dilatation for symptomatic cricopharyngeal bar. Gastrointest Endosc. 2005;61:148–52.PubMedCrossRef Wang AY, Kadkade R, Kahrilas PJ, Hirano I. Effectiveness of esophageal dilatation for symptomatic cricopharyngeal bar. Gastrointest Endosc. 2005;61:148–52.PubMedCrossRef
12.
go back to reference Lernau OZ, Sherzer E, Mogle P, Nissan S. Congenital cricopharyngeal achalasia treatment by dilatations. J Pediatr Surg. 1984;19:202–3.PubMedCrossRef Lernau OZ, Sherzer E, Mogle P, Nissan S. Congenital cricopharyngeal achalasia treatment by dilatations. J Pediatr Surg. 1984;19:202–3.PubMedCrossRef
13.
go back to reference Erdeve O, Kologlu M, Saygili B, Atasay B, Arsan S. Primary cricopharyngeal achalasia in a newborn treated by balloon dilatation: a case report and review of the literature. Int J Pediatr Otolaryngol. 2007;71:165–8.CrossRef Erdeve O, Kologlu M, Saygili B, Atasay B, Arsan S. Primary cricopharyngeal achalasia in a newborn treated by balloon dilatation: a case report and review of the literature. Int J Pediatr Otolaryngol. 2007;71:165–8.CrossRef
14.
go back to reference Solt J, Bajor J, Moizs M, Grexa E, Horvath PO. Primary cricopharyngeal dysfunction: treatment with catheter balloon dilatation. Gastrointest Endosc. 2001;54:767–71.PubMedCrossRef Solt J, Bajor J, Moizs M, Grexa E, Horvath PO. Primary cricopharyngeal dysfunction: treatment with catheter balloon dilatation. Gastrointest Endosc. 2001;54:767–71.PubMedCrossRef
15.
go back to reference Nagano H, Yoshifuku K, Kurono Y. Polymyositis with dysphagia treated with endoscopic balloon dilatation. Auris Nasus Larynx. 2009;36:705–8.PubMedCrossRef Nagano H, Yoshifuku K, Kurono Y. Polymyositis with dysphagia treated with endoscopic balloon dilatation. Auris Nasus Larynx. 2009;36:705–8.PubMedCrossRef
16.
go back to reference Rai RR, Shende A, Joshi A, Mathur A, Nijhawan S. Rigiflex pneumatic dilatation of achalasia without fluoroscopy: a novel office procedure. Gastrointest Endosc. 2005;62:427–31.PubMedCrossRef Rai RR, Shende A, Joshi A, Mathur A, Nijhawan S. Rigiflex pneumatic dilatation of achalasia without fluoroscopy: a novel office procedure. Gastrointest Endosc. 2005;62:427–31.PubMedCrossRef
17.
go back to reference Thomas W, Harish K, Sunilkumar K. Pneumatic dilatation of achalasia cardia under direct endoscopy: the debate continues. Gastrointest Endosc. 2006;63:734.PubMedCrossRef Thomas W, Harish K, Sunilkumar K. Pneumatic dilatation of achalasia cardia under direct endoscopy: the debate continues. Gastrointest Endosc. 2006;63:734.PubMedCrossRef
18.
go back to reference Lambroza A, Schuman RW. Pneumatic dilatation for achalasia without fluoroscopic guidance: safety and efficacy. Am J Gastroenterol. 1995;90:1226–9.PubMed Lambroza A, Schuman RW. Pneumatic dilatation for achalasia without fluoroscopic guidance: safety and efficacy. Am J Gastroenterol. 1995;90:1226–9.PubMed
19.
go back to reference Davis D, Nowicki M, Giles H. Cricopharyngeal achalasia responsive to balloon dilatation in an infant. South Med J. 2005;98:472–4.PubMedCrossRef Davis D, Nowicki M, Giles H. Cricopharyngeal achalasia responsive to balloon dilatation in an infant. South Med J. 2005;98:472–4.PubMedCrossRef
20.
go back to reference Riley SA, Attwood SE. Guidelines on the use of oesophageal dilatation in clinical practice. Gut. 2004;53(Suppl 1):i1–6.PubMedCrossRef Riley SA, Attwood SE. Guidelines on the use of oesophageal dilatation in clinical practice. Gut. 2004;53(Suppl 1):i1–6.PubMedCrossRef
21.
go back to reference Egan JV, Baron TH, Adler DG, Davila R, Faigel DO, Gan SL, Hirota WK, Leighton JA, Lichtenstein D, Qureshi WA, Rajan E, Shen B, Zuckerman MJ, VanGuilder T, Fanelli RD. Esophageal dilatation. Gastrointest Endosc. 2006;63:755–60.PubMedCrossRef Egan JV, Baron TH, Adler DG, Davila R, Faigel DO, Gan SL, Hirota WK, Leighton JA, Lichtenstein D, Qureshi WA, Rajan E, Shen B, Zuckerman MJ, VanGuilder T, Fanelli RD. Esophageal dilatation. Gastrointest Endosc. 2006;63:755–60.PubMedCrossRef
22.
go back to reference Dou ZL, Wang GF, Wang XH, Qiu WH, Lin JX, Lin JX, Pan WP. Stretching the cricopharyngeus muscle by urethral catheter balloon dilatation: a novel approach to treating dysphagia caused by cricopharyngeal achalasia. Chin J Phys Med Rehabil. 2006;28:166–70. Dou ZL, Wang GF, Wang XH, Qiu WH, Lin JX, Lin JX, Pan WP. Stretching the cricopharyngeus muscle by urethral catheter balloon dilatation: a novel approach to treating dysphagia caused by cricopharyngeal achalasia. Chin J Phys Med Rehabil. 2006;28:166–70.
23.
go back to reference Lan Y, Dou ZL, Wang GF, Li X. Efficacy of balloon dilatation therapy for cricopharyngeal achalasia in patients with brainstem lesions. Chin J Phys Med Rehabil. 2009;31:835–8. Lan Y, Dou ZL, Wang GF, Li X. Efficacy of balloon dilatation therapy for cricopharyngeal achalasia in patients with brainstem lesions. Chin J Phys Med Rehabil. 2009;31:835–8.
24.
go back to reference Wan GF, Hu XQ, Dou Zl, Lan Y, Xie CQ. Application of balloon dilatation for cricopharyngeal achalasia in children: a case report. Chin J Rehabil Theory Pract. 2010;16:279–80. Wan GF, Hu XQ, Dou Zl, Lan Y, Xie CQ. Application of balloon dilatation for cricopharyngeal achalasia in children: a case report. Chin J Rehabil Theory Pract. 2010;16:279–80.
25.
go back to reference Goyal RK, Martin SB, Shapiro J, Spechler SJ. The role of cricopharyngeus muscle in pharyngoesophageal disorders. Dysphagia. 1993;8:252–8.PubMedCrossRef Goyal RK, Martin SB, Shapiro J, Spechler SJ. The role of cricopharyngeus muscle in pharyngoesophageal disorders. Dysphagia. 1993;8:252–8.PubMedCrossRef
27.
go back to reference Carpenter DO. Central nervous system mechanism in deglutition and emesis. In: Wood JD, editor, Handbook of physiology, gastrointestinal system, vol. 4, motility and circulation. Washington, DC: American Physiology Society; 1984. Carpenter DO. Central nervous system mechanism in deglutition and emesis. In: Wood JD, editor, Handbook of physiology, gastrointestinal system, vol. 4, motility and circulation. Washington, DC: American Physiology Society; 1984.
28.
go back to reference Crary MA, Mann GD, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005;86:1516–20.PubMedCrossRef Crary MA, Mann GD, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005;86:1516–20.PubMedCrossRef
30.
go back to reference Bieger D, Hopkins DA. Viscerotropic representation of the upper alimentary tract in the medulla oblongata in the rat: the nucleus ambiguus. J Comp Neurol. 1987;262:546–62.PubMedCrossRef Bieger D, Hopkins DA. Viscerotropic representation of the upper alimentary tract in the medulla oblongata in the rat: the nucleus ambiguus. J Comp Neurol. 1987;262:546–62.PubMedCrossRef
31.
go back to reference Bao X, Wiedner EB, Altschuler SM. Transsynaptic localization of pharyngeal premotor neurons in rat. Brain Res. 1995;696:246–9.PubMedCrossRef Bao X, Wiedner EB, Altschuler SM. Transsynaptic localization of pharyngeal premotor neurons in rat. Brain Res. 1995;696:246–9.PubMedCrossRef
32.
go back to reference Hudson LC. The origins of innervation of the canine caudal pharyngeal muscles: an HRP study. Brain Res. 1986;374:413–8.PubMedCrossRef Hudson LC. The origins of innervation of the canine caudal pharyngeal muscles: an HRP study. Brain Res. 1986;374:413–8.PubMedCrossRef
Metadata
Title
The Effect of Different Catheter Balloon Dilatation Modes on Cricopharyngeal Dysfunction in Patients with Dysphagia
Authors
Zulin Dou
Yihe Zu
Hongmei Wen
Guifang Wan
Li Jiang
Youhong Hu
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
Dysphagia / Issue 4/2012
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-012-9402-4

Other articles of this Issue 4/2012

Dysphagia 4/2012 Go to the issue