Faculty Collaboration Database

Failure of cricopharyngeal myotomy to improve dysphagia following head and neck cancer surgery. Arch Otolaryngol Head Neck Surg 1999 Sep;125(9):942-6

Date

09/17/1999

Pubmed ID

10488976

DOI

10.1001/archotol.125.9.942

Scopus ID

2-s2.0-0032834208 (requires institutional sign-in at Scopus site)   28 Citations

Abstract

OBJECTIVE: To determine whether cricopharyngeal myotomy can improve dysphagia associated with head and neck cancer surgery.

DESIGN: Prospective, randomized, multicenter trial.

SETTING: Twelve clinical sites across the United States.

PATIENTS: Between 1989 and 1994, 125 patients undergoing combined modality therapy for head and neck cancer, including resection of the tongue base or supraglottic larynx, were prospectively entered into the trial.

INTERVENTION: Cricopharyngeal myotomy on a randomized basis.

MAIN OUTCOME MEASURES: Videofluoroscopic examination to determine oropharyngeal swallowing efficiency, which is defined as the ratio of percentage of the bolus swallowed to total swallowing time using 3 different bolus consistencies.

RESULTS: No significant difference in oropharyngeal swallowing efficiency between myotomy vs no myotomy was seen at 6 months of follow-up regardless of bolus consistency.

CONCLUSIONS: In this prospective test of cricopharyngeal myotomy, the procedure fails to significantly improve dysphagia associated with head and neck cancer surgery. The efficacy of this surgical procedure in other disease entities should also be rigorously explored.

Author List

Jacobs JR, Logemann J, Pajak TF, Pauloski BR, Collins S, Casiano RR, Schuller DE

Author

Barbara R. Pauloski PhD, CCC-SLP Associate Professor in the Communication Sciences & Disorders department at University of Wisconsin - Milwaukee

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell
Combined Modality Therapy
Deglutition Disorders
Female
Glossectomy
Humans
Laryngectomy
Male
Middle Aged
Otorhinolaryngologic Neoplasms
Pharyngeal Muscles
Postoperative Complications
Prospective Studies
Radiotherapy, Adjuvant
Reoperation
Treatment Outcome