Online citations, reference lists, and bibliographies.
Please confirm you are human
(Sign Up for free to never see this)
← Back to Search

Treatment Of Dysfunction Of The Cricopharyngeal Muscle With Botulinum A Toxin: Introduction Of A New, Noninvasive Method

I. Schneider, Claus Pototschnig, W. Thumfart, H. Eckel
Published 1994 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy
Share
Botulinum toxin is known as a relatively safe and efficacious agent for the treatment of various neurologic and ophthalmologic disorders. Since dysphagia and deglutition problems combined with aspiration are often caused by spasticity, hypertonus, or delayed relaxation of the upper esophageal sphincter (UES), conventional treatment including lateral cricopharyngotomy was replaced by localized injections of botulinum toxin into the cricopharyngeal muscle (CM) in a series of 7 patients. The study comprised patients with slight dysphagia caused by isolated hypertonus of the UES, as well as patients with severe deglutition disorders, complete inability to swallow, and aspiration problems. Preoperative diagnostic evaluation included careful history-taking, physical examination, cineradiography, and esophageal manometry to exclude other causes of dysphagia. For precise localization, injections were performed under general anesthesia after location of the CM by direct esophagoscopy and electromyographic guidance. Injections were administered into the dorsomedial part and on both sides into the ventrolateral parts of the muscle. Depending on the severity of symptoms and the intraluminal pressure of the UES, the dose varied between 80 and 120 units (botulinum toxin A from Dysport). The treatment outcome was evaluated by a disability rating score: patients' complaints were scored by subjective and objective parameters before and after injection. All but 2 patients experienced complete relief or marked improvement of their complaints. There were no severe side effects or postoperative complications. Local botulinum toxin injection proved to be an effective alternative treatment to invasive procedures for patients with isolated dysfunction of the UES, and also for patients with more complex deglutition problems combined with aspiration.
This paper references
10.1177/000348948909800202
Botulinum Toxin Injection for the Treatment of Oromandibular Dystonia
A. Blitzer (1989)
11.Treatment ofblepharospasm with botulinum toxin
EA Tsoi (1985)
10.1016/S0161-6420(87)33337-8
Use of botulinum toxin in the treatment of one hundred patients with facial dyskinesias.
J. Mauriello (1987)
Electromyography of the larynx and related technics.
W. Thumfart (1986)
10.1177/000348948409300108
Microendoscopic Surgery of the Hypopharyngeal Diverticulum Using Electrocoagulation or Carbon Dioxide Laser
J. V. van Overbeek (1984)
Functional and electrophysiologic diagnosis of dysphagia
Thumfart Wf (1990)
10.1056/NEJM199104253241707
Therapeutic uses of botulinum toxin.
J. Jankovic (1991)
Use of botulinum toxin in the treatment of one hundred patients with facial dys - kinesias
JA Mauriello (1987)
10.1001/ARCHOTOL.1988.01860240057024
Management of facial spasm with Clostridium botulinum toxin, type A (Oculinum)
A. W. Biglan (1988)
10.1016/0002-9394(85)90228-4
Treatment of blepharospasm with botulinum toxin.
E. A. Tsoy (1985)
10.1288/00005537-198802000-00015
Localized injections of botulinum toxin for the treatment of focal laryngeal dystonia (spastic dysphonia)
A. Blitzer (1988)
10.1016/B978-0-12-447180-1.50011-0
POSTSYNAPTIC EFFECTS OF BOTULINUM TOXIN AT THE NEUROMUSCULAR JUNCTION
L. Sellin (1981)
Treatment ofblepharo - spasm with botulinum toxin
EA Tsoi (1985)
Cricopharyngeal myotomy : in - dicationsandtechnique
JA McKenna
10.1002/MDS.870040401
Adductor laryngeal dystonia (spastic dysphonia): Treatment with local injections of botulinum toxin (Botox)
M. Brin (1989)
10.1016/S0161-6420(88)32977-5
Long-term results and complications of botulinum A toxin in the treatment of blepharospasm.
J. Dutton (1988)
10.1212/WNL.40.8.1213
Double‐blind, placebo‐controlled trial of botulinum toxin injections for the treatment of spasmodic torticollis
P. Greene (1990)
Electrodiagnosis of laryngeal nerve disorders.
W. Thumfart (1988)
10.1177/000348949210100304
Cricopharyngeal Myotomy: Indications and Technique
J. A. McKENNA (1992)
10.1177/000348949110000201
Laryngeal Dystonia: A Series with Botulinum Toxin Therapy
A. Blitzer (1991)
Endoscopic operations for hypopharyngeal diverticula ProcFourthIntCongrOtolaryngolLondon 1949:7157
G. Dohlman (1949)
10.1002/MDS.870020402
Localized injections of botulinum toxin for the treatment of focal dystonia and hemifacial spasm
M. Brin (1987)



This paper is referenced by
10.1179/136132808805297359
Pharyngeal Dysphagia and Botox: A Case Study
J. Gupta (2008)
10.1080/17474124.2019.1544890
Management of dysphagia in multiple sclerosis: current best practice
E. D'Amico (2019)
10.12786/BN.2009.2.2.113
Challenging Technique of Dysphagia
K. H. Choi (2009)
10.1016/B978-84-458-2022-3.50016-6
16 – Patología digestiva superior: trastornos de la deglución
Francisco Mora Miguel (2010)
10.1016/S1155-1968(06)45632-7
Troubles de la déglutition de l'adulte. Prise en charge diagnostique et thérapeutique
J. L. S. Guily (2006)
10.1067/MGE.2003.98
Botulinum toxin for spastic GI disorders: a systematic review.
Xiaotuan Zhao (2003)
10.1097/00019052-199908000-00012
Botulinum toxin in motor disorders.
A. Bentivoglio (1999)
10.1080/01443610050009674
Vaginismus: results of treatment with botulin toxin
A. S. O. El-Sibai (2000)
10.1007/BF03033934
Botulinum toxin for gastrointestinal disorders: Therapy and mechanisms
H. Vittal (2009)
10.1017/S0022215119000124
Pharyngeal pouch: comparison of surgical treatment with botulinum toxin injection to the cricopharyngeus.
K. Lau (2019)
10.1007/s00455-001-0064-x
Successful Botulinum Toxin Treatment of Dysphagia in a Young Child with Nemaline Myopathy
D. Restivo (2001)
10.1016/J.GIE.2006.04.010
Injection therapies for nonbleeding disorders of the GI tract.
R. W. Yeh (2006)
10.1055/S-2004-831085
Symptomatische Therapie der Multiplen Sklerose
T. Henze (2004)
10.1007/978-3-642-59453-3_14
Diagnostik, Klassifikation und Therapie von Schluckstörungen bei Patienten mit Multipler Sklerose
M. Prosiegel (2001)
10.1111/nyas.14456
Aspects of the assessment and management of pharyngoesophageal dysphagia
J. Allen (2020)
BIOMECHANICS OF FAILED DEGLUTITIVE UPPER ESOPHAGEAL SPHINCTER ( UES ) RELAXATION IN PATIENTS WITH NEUROGENIC DYSPHAGIA
R. B. Williams (2002)
10.1016/J.OTOT.2004.03.005
Botulinum toxin treatment of upper esophageal sphincter hyperfunction
L. Sulica (2004)
10.1097/MOO.0b013e328010b85b
Cricopharyngeal Botox injection: indications and technique
M. J. Moerman (2006)
10.1097/00042737-200105000-00024
Indications and efficacy of botulinum toxin in disorders of the gastrointestinal tract
A. Mandal (2001)
10.1007/978-3-662-10477-4_39
Erkrankungen der Speiseröhre
T. Sauerbruch (1999)
10.1007/s11926-020-00950-3
Impact and Management of Dysphagia in Inflammatory Myopathies
R. Zeng (2020)
10.1186/s13256-015-0647-z
Misdiagnosis of inclusion body myositis: two case reports and a retrospective chart review
A. Chilingaryan (2015)
10.1053/GAST.2000.20113
Successful botulinum toxin treatment of dysphagia in oculopharyngeal muscular dystrophy.
D. Restivo (2000)
10.1002/9781444346220.CH43
Esophageal Disease in Older Patients
K. Devault (2012)
10.1002/hed.10268
Cricopharyngeal spasm and Zenker's diverticulum
E. Veenker (2003)
10.5535/arm.2015.39.4.524
Effectiveness of Rehabilitative Balloon Swallowing Treatment on Upper Esophageal Sphincter Relaxation and Pharyngeal Motility for Neurogenic Dysphagia
Y. K. Kim (2015)
10.1016/S0022-5347(01)66376-6
Botulinum-A Toxin as a Treatment of Detruosor-Sphincter Dyssynergia: A Prospective Study in 24 Spinal Cord Injury Patients
B. Schurch (1996)
10.1007/978-3-030-28852-5_25
Laryngeal and Extralaryngeal Botulinum Toxin Injections
William Z. Gao (2020)
10.1177/0003489414525588
Dysphagia Due to Inclusion Body Myositis
Ellen H Ko (2014)
10.2147/IJGM.S198031
Dysphagia in Patients with Sporadic Inclusion Body Myositis: Management Challenges
Nika Mohannak (2019)
10.1016/J.PARKRELDIS.2006.06.002
Botulinum toxin: clinical use.
D. Truong (2006)
10.1023/B:DDAS.0000043373.20913.96
CASE REPORT: Endoscopic Balloon Catheter Dilation for Treatment of Primary Cricopharyngeal Dysfunction
S. Zepeda-Gómez (2004)
See more
Semantic Scholar Logo Some data provided by SemanticScholar