Persistent post-stroke dysphagia treated with cricopharyngeal myotomy

Area of Science:

• Neurology
• Gastroenterology
• Otolaryngology

Background:

• Post-stroke dysphagia affects 8-13% of patients, persisting for over 6 months.
• Refractory cases may necessitate percutaneous endoscopic gastrostomy (PEG), impacting quality of life.
• Cricopharyngeal dysfunction is a key factor in persistent post-stroke dysphagia.

Observation:

• A patient experienced persistent dysphagia following a vertebrobasilar stroke.
• The dysphagia was attributed to cricopharyngeal dysfunction.
• The patient had undergone the stroke 1.5 years prior to this intervention.

Findings:

• Cricopharyngeal myotomy was performed to address the cricopharyngeal dysfunction.
• The patient demonstrated significant recovery of swallowing function post-myotomy.
• This intervention was successful despite the long duration since the stroke.

Implications:

• Cricopharyngeal myotomy is a viable treatment for refractory post-stroke dysphagia.
• The procedure can improve quality of life by restoring oral intake.
• Timely surgical intervention may be beneficial even years after the initial stroke event.