Journal
ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY
Volume 116, Issue 1, Pages 49-56Publisher
ANNALS PUBL CO
DOI: 10.1177/000348940711600109
Keywords
dysphagia; fluoroscopy; oropharyngeal dysphagia; swallowing disorder; Zenker's diverticulum
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Objectives: Functional outcomes after open cricopharyngeal myotomy (CPM) for Zenker's diverticulum (ZD) and cricopharyngeal dysfunction without diverticulum (CPD) have not been uniformly measured by videofluorographic swallow study (VFSS). Here we characterize preoperative VFSS findings in these groups and evaluate the effect of CPM on swallowing via postoperative VFSS. Methods: We performed a retrospective review of paired preoperative and postoperative VFSS results from 50 patients (36 with ZD and 14 with CPD) over 6 years. Serniquantitative scales were used to assess 1) degree of stasis in the pharyngeal recesses; 2) degree of narrowing at the pharyngoesophageal sphincter (PES); 3) aspiration; and 4) diverticular size. Findings were compared between the groups and across subjects. Results: Pharyngeal stasis was more severe in Subjects with CPD than in subjects with ZD, both before and after CPM (p =.02 and p =.0002, respectively). The CPM improved PES narrowing in both groups (p =.03; p =.06) and reduced diverticular size in the ZD group (p <.001), but it did not significantly reduce the stasis severity or the proportion of patients with aspiration. Conclusions: According to VFSS, CPM opens LIP the PES and decreases diverticular size. More severe stasis in CPD suggests that diffuse pharyngeal weakness may play a role in this disease, and may partially explain the variable post-CPM outcomes that have been observed in CPD.
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