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Management of isolated cricopharyngeal dysfunction: systematic review
A Ashman1, O T Dale2, D L Baldwin1
1ENT Department,St Michael's Hospital,University Hospitals Bristol NHS Foundation Trust,UK.
The Journal of Laryngology and Otology
|May 20, 2016
Summary
This systematic review evaluates treatments for isolated cricopharyngeal dysfunction. Endoscopic myotomy is effective and less invasive than open surgery, while other therapies suit specific patient groups.
Area of Science:
- Otolaryngology
- Gastroenterology
- Deglutition Disorders
Background:
- Cricopharyngeal dysfunction can significantly impair swallowing.
- Various therapeutic interventions exist for managing this condition.
- A comprehensive evaluation of their safety and efficacy is needed.
Purpose of the Study:
- To systematically review and evaluate the safety and efficacy of therapeutic interventions for isolated cricopharyngeal dysfunction.
Main Methods:
- A systematic literature search was conducted across multiple databases (Ovid, Cochrane Library, PubMed, Google Scholar).
- Initial search yielded 339 articles; 47 were included in the qualitative analysis after title/abstract review and detailed inspection.
- No randomized controlled trials were identified; analysis relied on case series.
Main Results:
- Botulinum toxin A injection and cricopharyngeal dilatation showed higher recurrence rates but are suitable for elderly/co-morbid patients.
- Endoscopic myotomy demonstrated comparable efficacy to open surgery with reduced morbidity.
- Qualitative analysis of case series provided insights into treatment outcomes.
Conclusions:
- Current therapeutic options for isolated cricopharyngeal dysfunction are generally safe and effective.
- Further research is necessary to directly compare the efficacy of different treatment modalities.
- Evidence supports endoscopic myotomy as a less morbid surgical option.
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