Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-27T23:16:23.394Z Has data issue: false hasContentIssue false
  • English
  • Français

Efficacy of fluoroscopy-guided endoscopic cricopharyngeal myotomy

Published online by Cambridge University Press:  24 January 2019

K Fujiwara ,
K Kawamoto ,
K Taira ,
T Fukuhara ,
S Koyama ,
H Kataoka ,
H Kitano  and
H Takeuchi
K Fujiwara*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
K Kawamoto
Affiliation:
Department of Otolaryngology, Head and Neck Thyroid Surgery, Kusatsu General Hospital, Japan
K Taira
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
T Fukuhara
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
S Koyama
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
H Kataoka
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
H Kitano
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
H Takeuchi
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
*
Author for correspondence: Dr Kazunori Fujiwara, Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, 36-1 Nishimachi, Yonago 683-8504, Japan E-mail: kfujiwa@med.tottori-u.ac.jp Fax: +81 859 38 6629
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

In endoscopic cricopharyngeal myotomy, surgeons sometimes have concerns about performing an adequate incision with only a narrow intra-cavital view from one direction. In order to overcome these issues, fluoroscopic radiography was used during endoscopic cricopharyngeal myotomy.

Methods

Peri-operative fluoroscopic radiography was utilised to check the position of the diverticuloscope, and to confirm the extent of the incision during surgery. A balloon catheter was used to determine whether the cricopharyngeal muscle was sufficiently resected. Blood loss, peri-operative complications, and functional oral swallowing scale and penetration aspiration scale scores were evaluated.

Results

In 12 out of 15 patients, intra-operative fluoroscopic radiography showed the diverticuloscope positioned in the post-cricoid area, and the cricopharyngeal muscle was raised and the surgery completed without adverse effect. Swallowing functions improved following surgery.

Conclusion

Intra-operative fluoroscopy might improve endoscopic cricopharyngeal myotomy by allowing surgeons to confirm the extent of resection, and by reducing peri-operative morbidity and complication rates.

Keywords

Endoscopic Cricopharyngeal MyotomyIntraoperative Fluoroscopic ImagingBalloon CatheterFunctional Oral Swallowing ScalePenetration Aspiration ScaleDysphagia
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 12 , December 2018 , pp. 1128 - 1133
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr K Fujiwara takes responsibility for the integrity of the content of the paper

References

1Halvorson, DJ, Kuhn, FA. Transmucosal cricopharyngeal myotomy with the potassium-titanyl-phosphate laser in the treatment of cricopharyngeal dysmotility. Ann Otol Rhinol Laryngol 1994;103:173–7Google Scholar
2Pitman, M, Weissbrod, P. Endoscopic CO2 laser cricopharyngeal myotomy. Laryngoscope 2009;119:45–53Google Scholar
3Aiolfi, A, Scolari, F, Saino, G, Bonavina, L. Current status of minimally invasive endoscopic management for Zenker diverticulum. World J Gastrointest Endosc 2015;7:87–93Google Scholar
4Takes, RP, van den Hoogen, FJ, Marres, HA. Endoscopic myotomy of the cricopharyngeal muscle with CO2 laser surgery. Head Neck 2005;27:703–9Google Scholar
5Dauer, E, Salassa, J, Luga, L, Kasperbauer, J. Endoscopic laser vs open approach for cricopharyngeal myotomy. Otolaryngol Head Neck Surg 2006;134:830–5Google Scholar
6Bergeron, JL, Chhetri, DK. Indications and outcomes of endoscopic CO2 laser cricopharyngeal myotomy. Laryngoscope 2014;124:950–4Google Scholar
7Hoesseini, A, Honings, J, Taus-Mohamedradja, R, van den Hoogen, FJ, Marres, HA, van den Broek, GB et al. Outcomes of endoscopic cricopharyngeal myotomy with CO2 laser surgery: a retrospective study of 47 patients. Head Neck 2016;38:1022–7Google Scholar
8Bachy, V, Matar, N, Remacle, M, Jamart, J, Lawson, G. Long-term functional results after endoscopic cricopharyngeal myotomy with CO2 laser: a retrospective study of 32 cases. Eur Arch Otorhinolaryngol 2013;270:965–8Google Scholar
9Brouillette, D, Martel, E, Chen, LQ, Duranceau, A. Pitfalls and complications of cricopharyngeal myotomy. Chest Surg Clin N Am 1997;7:457–75;discussion 476Google Scholar
10Lindgren, S, Ekberg, O. Cricopharyngeal myotomy in the treatment of dysphagia. Clin Otolaryngol Allied Sci 1990;15:221–7Google Scholar