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Cricopharyngeal myotomy

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https://www.readbyqxmd.com/read/29616239/cricopharyngeal-myotomy-with-thulium-laser-through-flexible-endoscopy-proof-of-concept-study
#1
Stefano Siboni, Alberto Aiolfi, Chiara Ceriani, Gian Eugenio Tontini, Luigi Bonavina
Background and study aims : Endoscopic treatment of Zenker's diverticulum has proven feasible, but electrocautery and CO 2 laser technology carry the risk of collateral thermal injury. Thulium laser septum incision may overcome this limitation. We describe for the first time the use of thulium laser through flexible endoscopy in a small cohort of patients with Zenker diverticulum. Patients and methods : Thulium laser septum division was performed via flexible endoscopy under general anesthesia in consecutive symptomatic patients with primary or recurrent Zenker diverticulum...
April 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29482980/esophageal-obstruction-due-to-a-right-sided-zenker-diverticulum
#2
S Mantziari, C Mariette, G Piessen
A Zenker's or pharyngoesophageal diverticulum may represent a rare cause of upper digestive obstruction, or more often, cervical dysphagia, regurgitations and cough. It develops most often on the posterior left side of cervical oesophagus in elderly patients, and depending on the severity of clinical symptoms may warrant surgical or endoscopic treatment. For large lesions with a difficult endoscopic access to the diverticular neck, surgery is recommended. In our case, we illustrate a giant right-sided Zenker's diverticulum responsible for complete aphagia in a 78-year-old male patient...
February 23, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29447795/modified-approach-for-pediatric-external-cricopharyngeal-myotomy
#3
Suresh Mohan, Sarah N Bowe, Lara M Hirner, Claire Zar-Kessler, Christopher J Hartnick
Pediatric cricopharyngeal achalasia is an uncommon but important cause of oropharyngeal dysphagia. Failure of upper esophageal sphincter relaxation is the currently understood pathophysiology. Therapies include balloon dilation, botulinum toxin injection, and endoscopic or open cricopharyngeal myotomy (CPM). Open CPM is usually performed at the posterior midline of the cricopharyngeus and can be a risky procedure given concern for esophageal perforation and damage to the recurrent laryngeal nerve. Here, we present a novel modified technique for open CPM using a superficial anterolateral transection approach in the case of a young male with refractory cricopharyngeal achalasia...
February 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29366609/surgical-treatment-of-enterovirus-d68-brainstem-encephalitis-induced-dysphagia
#4
Takafumi Togashi, Hironori Baba, Meiko Kitazawa, Nao Takahashi, Yasuhiro Samejima, Eiji Yumoto, Arata Horii
Cluster of acute flaccid paralysis and cranial nerve dysfunction was associated with a 2014 outbreak of enterovirus D68 (EV-D68) respiratory illness in US. We describe a 33 year-old male patient of refractory dysphagia due to EV-D68-induced brainstem encephalitis successfully treated by surgery. Following acute upper respiratory tract infection, he developed dysphagia and bilateral facial paralysis. A coughing reflex was readily produced when the laryngopharyngeal fiberscope touched the epiglottis, however, water infusion induced only very weak and slow swallowing reflex, suggesting that only motor component was impaired but sensory function was preserved during swallowing...
January 20, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29327499/five-year-outcome-of-endoscopic-laser-cricopharyngeal-myotomy-our-experience-in-ten-patients
#5
LETTER
J H Bird, E Warner, R Corbridge
No abstract text is available yet for this article.
January 11, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29280482/national-trends-in-primary-tracheoesophageal-puncture-after-total-laryngectomy
#6
Rosh K V Sethi, Daniel G Deschler
OBJECTIVES/HYPOTHESIS: Tracheoesophageal puncture (TEP) can be performed at the time of laryngectomy (primary) or postoperatively (secondary). Prior studies demonstrate safe and earlier voice acquisition and rehabilitation with primary TEP. The objectives of this study were to assess national trends in primary TEP and identify factors associated with its use. STUDY DESIGN: Retrospective review. METHODS: Retrospective analysis of the Nationwide Inpatient Sample (NIS) from 2010 to 2014 was performed...
December 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29083513/swallowing-outcomes-after-cricopharyngeal-myotomy-a-systematic-review
#7
Molly A Knigge, Susan L Thibeault
BACKGROUND: No practice guidelines have been established for swallowing outcomes after cricopharyngeal myotomy (CPM). The purpose of this systematic review was to summarize evidence for swallowing outcomes in patients undergoing CPM to treat symptomatic cricopharyngeal dysfunction, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol. METHODS: Swallowing outcomes examined included penetration/aspiration ratings, manometric measures, patient-rated dysphagia scales, clinician-rated dysphagia scales, diet level, and weight...
January 2018: Head & Neck
https://www.readbyqxmd.com/read/29050088/-laryngeal-endoscopic-cricopharyngeal-myotomy-for-cricopharyngeal-achalasia-post-stroke
#8
J Wang, W Y Li, Y J Li, D H Yang, H Huo, X F Jin, Y Y Niu, X Tian, Z H Zhang, Y Chen, Z Q Gao
Objective: To explore the safety and validity of endoscopic cricopharyngeal myotomy in patients with cricopharyngeal achalasia. Methods: A total of 19 patients with cricopharyngeal achalasia suffered from sustained dysphagia were enrolled in this study. The patients were divided into transcervical cricopharyngeal myotomy(CPM) group and endoscopic CPM (ECPM) group. Swallowing function and complications were evaluated.SPSS7.0 software was used to analyze the data. Results: The swallowing function improved significantly in seven patients in ECPM group, and 9 patients improved in CPM group...
October 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28964284/management-of-cricopharyngeal-achalasia-in-an-8-month-child-using-endoscopic-cricopharyngeal-myotomy
#9
Cinzia Marchica, Faisal Zawawi, Sam J Daniel
A term baby was transferred to our tertiary care center with desaturations and inability to manage upper airway secretions. Rigid bronchoscopy and swallowing study revealed cricopharyngeal (CP) achalasia. A gastrostomy tube insertion and Botulinum Toxin-A injection were performed at 6 weeks of age. Improvement of symptoms was observed, however were short-lived requiring recurrent injections. Given the symptom severity, at 8 months, a successful endoscopic CP myotomy was performed. Patient was able to tolerate oral feeds as early as 2 months post-operatively...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28956250/hypopharyngeal-applications-of-a-new-flexible-robotic-system-in-otolaryngology
#10
Janet Ren Chao, Joseph Goodman, Andrew Fuson, Nahir J Romero, Arjun Joshi
This case report describes the use a new flexible robotic system in otolaryngology, the FlexRobot(®) for cricopharyngeal myotomy in cadaver dissections, and for the treatment of a patient with esophageal stenosis and secondary dysphagia and dysphonia. The Flexrobot(®) facilitates access to the hypopharynx with increased proximity to the surgical field and improved optics, allowing more exact dilatation and injection in our patient. It also would allow surgeons to reach deep inside the cavity of the hypopharynx into anatomical regions that are typically inaccessible without an open approach, as shown in our cadaveric procedure, where full exposure of the posterior aspect of the cricopharyngeus and isolation of the muscle belly were achieved...
September 27, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28731572/endoscopic-surgical-technique-for-benign-fibrotic-strictures-of-the-upper-esophageal-sphincter
#11
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 swallowing and weight loss underwent videofluorographic examination of swallowing, which revealed severely reduced cricopharyngeal opening. Endoscopic cricopharyngeal myotomy was carried out 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 done 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
#12
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.
September 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28644552/assessment-of-videofluoroscopic-swallow-study-findings-before-and-after-cricopharyngeal-myotomy
#13
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
#14
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)...
January 2018: 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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