Botulinum toxin type A for poststroke cricopharyngeal muscle dysfunction.

Area of Science:

• Neurology
• Gastroenterology
• Otolaryngology

Background:

• Post-stroke dysphagia is common, often linked to cricopharyngeal muscle dysfunction.
• Impaired swallowing significantly impacts patient quality of life and nutritional status.

Purpose of the Study:

• To assess the therapeutic efficacy of botulinum toxin type A (BTX-A) for post-stroke cricopharyngeal muscle dysfunction.
• To evaluate the safety and effectiveness of BTX-A in improving swallowing in affected patients.

Main Methods:

• A before-after trial was conducted involving eight post-stroke patients.
• Botulinum toxin type A (BTX-A) was injected into the cricopharyngeal muscle under endoscopic guidance.
• Outcomes were measured using clinical symptom scores, disability rating scales for swallowing, videofluoroscopic swallowing studies, and upper esophageal sphincter (UES) manometry.

Main Results:

• Significant improvements in clinical symptom scores and swallowing impairment were observed at 2 and 12 weeks post-injection (P<.05).
• Reduced residue in the piriform sinus and improved UES pressure were noted at 2 weeks, though not significant at 12 weeks.
• No adverse side effects were reported during the study period.

Conclusions:

• Botulinum toxin type A (BTX-A) injection appears to be a safe and effective treatment option for cricopharyngeal muscle dysfunction in post-stroke patients.
• BTX-A offers a promising therapeutic avenue for improving swallowing function and related symptoms.