Allen Jacqui, Blair Dora, Miles Anna
Department of Otolaryngology, Waitemata District Health Board, Auckland, New Zealand.
Department of Surgery, University of Auckland, Auckland, New Zealand.
Head Neck. 2017 Sep;39(9):1869-1875. doi: 10.1002/hed.24846. Epub 2017 Jun 23.
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.
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.
Forty cricopharyngeal myotomies were performed (mean age 76 years; SD 8.72) all for dysphagia. Symptomatic improvement (change in EAT-10 scores) occurred in 95% (38/40). Presurgical versus postsurgical VFSS demonstrated significantly improved pharyngoesophageal segment opening, pharyngeal constriction ratio, and pouch residue (P < .01). Symptomatic improvement was unrelated to the presence of retained barium.
Both symptomatic and objective improvement in swallowing measures occurs after cricopharyngeal myotomy. Pouch remnants and retained barium are seen postoperatively but do not correlate with reported symptoms. Routine follow-up barium studies may be needed to establish a new baseline and allow for comparison if future symptom recurrence occurs.
环咽肌切开术是治疗梗阻性环咽肌功能障碍和Zenker憩室炎的一种方法。关于造影研究结果及其与患者症状的相关性报道较少。
所有接受环咽肌切开术治疗的患者均在术前和术后接受了视频荧光吞咽造影检查（VFSS），并完成了自我报告的饮食评估工具（EAT-10）。对研究进行了定量分析。
共进行了40例环咽肌切开术（平均年龄76岁；标准差8.72），均用于治疗吞咽困难。95%（38/40）的患者症状得到改善（EAT-10评分变化）。术前与术后的VFSS显示，咽食管段开口、咽收缩率和憩室残留均有显著改善（P <.01）。症状改善与钡剂残留无关。
环咽肌切开术后吞咽指标在症状和客观方面均有改善。术后可见憩室残留和钡剂残留，但与报告的症状无关。可能需要进行常规的随访钡剂检查，以建立新的基线，并在未来症状复发时进行比较。
