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Cricopharyngeal myotomy

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https://www.readbyqxmd.com/read/28731572/endoscopic-surgical-technique-for-benign-fibrotic-strictures-of-the-upper-esophageal-sphincter
#1
Shun-Ichi Chitose, Kiminori Sato, Mioko Fukahori, Sachiyo Hamakawa, Akari Koga, Shintaro Sueyoshi, Hirohito Umeno
A 43-year-old man with complaints of increased difficulty of swallowing and weight loss underwent videofluorographic examination of swallowing, which revealed severely reduced cricopharyngeal opening. Endoscopic cricopharyngeal myotomy was performed using a modified technique (mECPM). A benign fibrotic stricture of the upper esophageal sphincter (UES) was identified under visualization of a distending operating laryngoscope. A vertical midline incision in the strictured mucosa and submucosal resection of the cricopharyngeal muscle were performed using a CO2 laser...
July 21, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28689425/endoscopic-retreatment-of-zenker-s-diverticulum-using-novel-endoscopic-scissors-the-clutch-cutter-device
#2
Nicolás González, Dardo Debenedetti, Andrés Taullard
Treatment of Zenker's diverticulum by flexible endoscopy consists of the myotomy of the cricopharyngeal muscle and is considered to be feasible, effective and safe. This report describes the novel use of a Clutch Cutter® device to perform flexible endoscopic retreatment of a symptomatic recurrence after previous treatment using a Needle knife in a 68 year old woman with symptoms of dysphagia for solids.
July 10, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28644552/assessment-of-videofluoroscopic-swallow-study-findings-before-and-after-cricopharyngeal-myotomy
#3
Jacqui Allen, Dora Blair, Anna Miles
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...
June 23, 2017: Head & Neck
https://www.readbyqxmd.com/read/28639039/a-novel-endoscopic-surgery-for-dysphagia-after-stroke
#4
Jian Wang, Wuyi Li, Yongjin Li, Xiaofeng Jin, Yanyan Niu, Xu Tian, Hong Huo
BACKGROUND: Dysphagia is a common complication in stroke patients, which severely affects quality of life. This study aimed to evaluate the effectiveness and safety of temperature-controlled plasma radiofrequency (coblation)-assisted endoscopic cricopharyngeal myotomy (CAECPM) for the treatment sustained (>6 months) dysphagia in stroke patients. METHODS: This retrospective case-control study included a total of 24 stroke patients with sustained dysphagia, who were either treated with transcervical cricopharyngeal myotomy (CPM) (n = 16) or CAECPM (n = 12)...
June 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28607897/a-comparative-study-of-pharyngeal-repair-in-two-layers-versus-three-layers-following-total-laryngectomy-in-carcinoma-of-larynx
#5
Asok K Saha, Saikat Samaddar, Avijit Choudhury, Abir Chaudhury, Nirmalya Roy
Larynx is the second most common site for cancer in the upper aerodigestive tract. One of the dreaded complications following total laryngectomy has been pharyngo cutaneous fistula (PCF). PCF merits special attention due to its significant negative impact on the recovery process. Total laryngectomy profoundly alters speech. Effective voice restoration is essential for the rehabilitation of these patients. Inadequate consensus exists as to the best technique of pharyngeal repair to decrease incidence of PCF and ensure good quality voice following total laryngectomy...
June 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28416345/laryngeal-function-preserving-operation-for-t4a-laryngeal-cancer-with-vocal-cord-paralysis-a-case-report
#6
Yukinori Asada, Koreyuki Kurosawa, Ko Matsumoto, Takahiro Goto, Kengo Katoh, Takayuki Imai, Shigeru Saijo, Kazuto Matsuura
For locally advanced laryngeal cancers, the standard treatment of choice is chemoradiotherapy if organ function needs to be conserved. Surgical treatment with larynx preservation is conducted only for limited cases. For locally advanced laryngeal cancers such as those with vocal cord fixation and/or cricoid cartilage destruction, there is no apparent standardized organ-preserving surgery keeping the essential laryngeal functions, viz. the airway, deglutition and articulation, uncompromized. Recently, our surgical team saw a patient with T4a advanced laryngeal cancer with vocal cord fixation who aspired to maintain his laryngeal function...
April 14, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28390804/open-vs-endoscopic-cricopharyngeal-myotomy-is-there-a-difference
#7
Colin Huntley, Maurits Boon, Joseph Spiegel
INTRODUCTION: The upper esophageal sphincter (UES) is composed largely of the cricopharyngeus muscle (CP) and acts as the gatekeeper to the esophagus. There are multiple methods of treating UES dysfunction, but myotomy has been shown to be the most definitive means. We aim to evaluate the difference between open and endoscopic CP myotomy (CPM). METHODS: A retrospective review of all patients undergoing endoscopic and open CPM was undertaken. We recorded demographic, clinical, operative, hospital, and postoperative data for both groups from January 2010-March 2015...
March 31, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27938463/effectiveness-of-endoscopic-cricopharyngeal-myotomy-in-adults-with-neurological-disease-systematic-review
#8
REVIEW
Ó Gilheaney, P Kerr, S Béchet, M Walshe
OBJECTIVE: To determine the effectiveness of endoscopic cricopharyngeal myotomy on upper oesophageal sphincter dysfunction in adults with upper oesophageal sphincter dysfunction and neurological disease. DATA SOURCES: Published and unpublished studies with a quasi-experimental design investigating endoscopic cricopharyngeal myotomy effects on upper oesophageal sphincter dysfunction in humans were considered eligible. Electronic databases, grey literature and reference lists of included studies were systematically searched...
December 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27809552/utility-of-surgical-myotomy-in-the-dysphagia-due-to-oculopharyngeal-dystrophy
#9
M ª Asunción Acosta Mérida, Joaquín Marchena Gómez, Josefa M ª Afonso Déniz
Oculopharyngeal muscular dystrophy (OPMD), is a rare hereditary myopathy that affects mainly the levator palpebrae and the constrictor pharyngeal muscles, being able to cause severe dysphagia. It can be treated effectively by surgical cricopharyngeal myotomy, as in the case presented below.
December 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27775286/-cricopharyngeal-achalasia-diagnosis-and-therapeutic-alternatives
#10
P Rodríguez Iglesias, V Ibáñez Pradas, A Alamar Velázquez, I Ibáñez Alcañiz, M Couselo Jerez
INTRODUCTION: The cricopharyngeal achalasia is an esophageal motor disorder that entails a lack of relaxation of the upper esophageal sphincter. It is rare in children and its etiology is related to multiple factors. The symptoms are nonspecific and may be masked by other diseases. CLINICAL CASE: Report two infants with dysphagia and choking episodes. Upper gastrointestinal series confirmed cricopharyngeal achalasia. The first patient was treated with endoscopic dilatation, and did not require further therapies...
April 15, 2015: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27525244/acquired-pharyngeal-diverticulum-after-anterior-cervical-fusion-operation-misdiagnosed-as-typical-zenker-diverticulum
#11
Jong Myung Park, Chang Wan Kim, Do Hyung Kim
A pharyngeal diverticulum is a rare complication of an anterior cervical discectomy and fusion (ACDF). We present a case of a pharyngeal diverticulum after an ACDF, which was misdiagnosed as a typical Zenker diverticulum. A 54-year-old woman presented with dysphagia and a sense of irritation in the neck following C5 through C7 cervical fusion 3 years prior. The patient underwent open surgery to resect the diverticulum with concurrent cricopharyngeal myotomy. An ACDF-related diverticulum is difficult to distinguish from a typical Zenker diverticulum...
August 2016: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27522437/treatment-of-oropharyngeal-dysphagia-secondary-to-idiopathic-cricopharyngeal-bar-surgical-cricopharyngeal-muscle-myotomy-versus-dilation
#12
Alexander P Marston, Francisco J Maldonado, Karthik Ravi, Jan L Kasperbauer, Dale C Ekbom
OBJECTIVE: To compare swallowing outcomes following cricopharyngeal (CP) dilation versus surgical myotomy in patients with dysphagia secondary to idiopathic CP bar. METHODS: All patients had an idiopathic CP bar without a history of Zenker's diverticulum, head and neck cancer, or systemic neurologic disease treated between 2000 and 2013. The Functional Outcome Swallowing Scale (FOSS) was utilized to assess dysphagia symptoms. RESULTS: Twenty-three patients underwent 46 dilations and 20 patients had a myotomy...
November 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27322751/flexible-endoscopic-treatment-of-zenker-s-diverticulum-thirteen-years-experience-in-spain
#13
Emilio Jesús de la Morena Madrigal, Elena Pérez Arellano, Isabel Rodríguez García
INTRODUCTION: Flexible endoscopic treatment is one of the alternative approaches for the management of Zenker's diverticum. The present paper shows our short-term and long-term results with flexible endoscopic cricopharyngeal myotomy/septotomy. PATIENTS AND METHODS: A retrospective analysis of our experience in patients with Zenker's diverticulum treated using a flexible endoscope, assisted by a flexible diverticuloscope, between 2002 and 2015. Myotomy/septotomy was performed with a needle-knife papillotome under deep sedation or general anesthesia...
June 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27293339/persistent-post-stroke-dysphagia-treated-with-cricopharyngeal-myotomy
#14
Sruthi S Nair, Arathy Jalaja Surendaran, Jayakumar R Menon, Sapna Erat Sreedharan, Padmavathy N Sylaja
Post-stroke dysphagia is a common problem after stroke. About 8-13% patients have persistent dysphagia and are unable to return to pre-stroke diet even after 6 months of stroke. Use of percutaneous endoscopic gastrostomy (PEG) may be required in these patients, which may be psychologically unacceptable and impair the quality of life. In those with cricopharyngeal dysfunction leading on to refractory post-stroke dysphagia, cricopharyngeal myotomy and injection of botulinum toxin are the treatment options. We present a case of vertebrobasilar stroke who had persistent dysphagia due to cricopharyngeal dysfunction with good recovery of swallowing function following cricopharyngeal myotomy 1...
April 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27282273/flexible-endoscopic-cricopharyngeal-myotomy-the-gold-standard-for-the-management-of-zenker-s-diverticulum
#15
Diego Juzgado Lucas
The prevalence of Zenker's diverticulum (ZD) is difficult to estimate. If we focus on some published data, it may be as low as 2 new cases per 100,000 inhabitants per year in the United Kingdom, which is in contrast the with feeling in some endoscopy units, that this condition's prevalence is increasing year after year. Prevalence likely remains the same as ever, but the addition of factors such as population ageing, optimal diagnostic care, availability of effective endoscopic management, increased awareness, and cumulative experience in some endoscopy teams, may well have increasingly brought this condition to our attention in our daily practice...
June 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27225511/primary-tracheoesophageal-puncture-and-cricopharyngeal-myotomy-in-stapler-assisted-total-laryngectomy
#16
D M Beswick, E J Damrose
OBJECTIVE: To evaluate the utility of the hybrid tracheoesophageal puncture procedure in stapler-assisted laryngectomy. METHODS: Patients who underwent total laryngectomy at a single institution from 2009 to 2015 were reviewed. The interventions assessed were surgical creation of a tracheoesophageal puncture and placement of a voice prosthesis. The outcomes measured included voicing ability and valve failure. RESULTS: Thirty-nine patients underwent total laryngectomy or pharyngolaryngectomy...
July 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27194375/management-of-isolated-cricopharyngeal-dysfunction-systematic-review
#17
REVIEW
A Ashman, O T Dale, D L Baldwin
OBJECTIVE: A systematic review was performed to evaluate the safety and efficacy of different therapeutic interventions available for the management of isolated cricopharyngeal dysfunction. METHODS: Studies were identified using the following databases: Ovid (Medline, Embase), the Cochrane Library, PubMed and Google Scholar. An initial search identified 339 articles. All titles and abstracts were reviewed. Fifty-six relevant articles were inspected in more detail; of these, 47 were included in the qualitative analysis...
July 2016: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27049450/improvement-in-the-reflux-symptom-index-following-surgery-for-cricopharyngeal-dysfunction
#18
Nancy Jiang, C Kwang Sung, Edward J Damrose
OBJECTIVES: Gastroesophageal reflux may contribute to the development of cricopharyngeal dysfunction and Zenker's diverticulum. Common dictum suggests that if upper esophageal sphincter tone is reduced through cricopharyngeal myotomy, symptoms of laryngopharyngeal reflux may worsen. We hypothesized that patients who undergo myotomy should show decreased dysphagia symptoms with concurrent worsening of reflux symptomatology and that these changes would be greater in those patients undergoing complete versus partial myotomy...
January 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/27010588/does-residual-wall-size-or-technique-matter-in-the-treatment-of-zenker-s-diverticulum
#19
Rupali N Shah, Keimun A Slaughter, Lauren W Fedore, Benjamin Y Huang, Allison M Deal, Robert A Buckmire
OBJECTIVES/HYPOTHESIS: We aimed to compare three surgical techniques (open approach for diverticulectomy with cricopharyngeal myotomy [OA], endoscopic laser-assisted diverticulotomy [ELD], and endoscopic stapler-assisted diverticulotomy [ESD]) for treatment of Zenker's diverticulum with regard to validated swallowing outcomes, radiographic outcomes, complications, and revision rates. We statistically analyzed whether the size of residual postoperative party wall or the specific surgical technique correlates with swallowing outcomes...
November 2016: Laryngoscope
https://www.readbyqxmd.com/read/26956900/evolving-management-of-zenker-s-diverticulum-in-the-endoscopic-era-a-north-american-experience
#20
COMPARATIVE STUDY
Daniel Jones, Abdullah Aloraini, Stephen Gowing, Jonathan Cools-Lartigue, Mara Leimanis, Roger Tabah, Lorenzo Ferri
BACKGROUND: Open surgical cricopharyngeal myotomy(CM) is considered standard of care for Zenker's diverticulum(ZD). Trans-oral CM has been described using a rigid stapling device for two decades; however, this remains problematic for severely kyphotic patients. This problem can be overcome with flexible endoscopy utilizing an electrosurgical needle knife. We sought to compare clinical outcomes between these techniques to stratify patient selection. METHODS: Patients undergoing ZD treatment from 1992 to 2015 were reviewed...
June 2016: World Journal of Surgery
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