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Assessment of videofluoroscopic swallow study findings before and after cricopharyngeal myotomy
Author(s) -
Allen Jacqui,
Blair Dora,
Miles Anna
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24846
Subject(s) - cricopharyngeal myotomy , medicine , myotomy , dysphagia , swallowing , surgery , pouch , achalasia , esophagus
Abstract Background Cricopharyngeal myotomy is a treatment for obstructive cricopharyngeal bar and Zenker's diverticulitis. Little is reported regarding contrast study findings and their correlation with patient symptoms. Methods All patients treated by cricopharyngeal myotomy underwent a preoperative and postoperative videofluoroscopic swallow study (VFSS) and completed the self‐reported Eating Assessment Tool (EAT‐10). Studies were analyzed quantitatively. Results Forty cricopharyngeal myotomies were performed (mean age 76 years; SD 8.72) all for dysphagia. Symptomatic improvement (change in EAT‐10 scores) occurred in 95% (38/40). Presurgical versus postsurgical VFSS demonstrated significantly improved pharyngoesophageal segment opening, pharyngeal constriction ratio, and pouch residue ( P < .01). Symptomatic improvement was unrelated to the presence of retained barium. Conclusion Both symptomatic and objective improvement in swallowing measures occurs after cricopharyngeal myotomy. Pouch remnants and retained barium are seen postoperatively but do not correlate with reported symptoms. Routine follow‐up barium studies may be needed to establish a new baseline and allow for comparison if future symptom recurrence occurs.