Joo So Young, Lee Seung Yeol, Cho Yoon Soo, Seo Cheong Hoon
Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.
Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
J Burn Care Res. 2019 Aug 14;40(5):710-713. doi: 10.1093/jbcr/irz044.
Deglutition disorder is a clinical symptom that has been associated with inhalation and cutaneous thermal burn injuries. Deglutition disorder is present in approximately 11% of patients with burn injury and is known to persist for weeks to months postinjury. Here, we report a case of deglutition disorder associated with cricopharyngeal dysfunction in a patient with thermal burn injury. Two patients presented with deglutition disorder lasting for several weeks after thermal injury. Clinically, it manifested as combined liquid and solid food dysphagia. The findings of videofluoroscopic swallow study (VFSS) were poor relaxation of the pharyngoesophageal sphincter (PES), decreased elevation of the laryngohyoid, and inadequate pharyngeal contraction. The PES was dilated with a 20-mm expansion balloon catheter multiple times. The symptoms of deglutition disorder were relieved immediately after the procedure. Balloon catheter dilatation was performed four times at 1- to 2-week intervals. Follow-up VFSS showed that poor relaxation of the PES was improved. The VFSS showed no recurrence at the 3-month follow-up. We found that balloon catheter dilatation for treatment of a patient with cricopharyngeal dysfunction after thermal burn injury was effective, ease of use, and safe.
吞咽障碍是一种与吸入性和皮肤热烧伤相关的临床症状。约11%的烧伤患者存在吞咽障碍，且已知在受伤后数周甚至数月持续存在。在此，我们报告1例热烧伤患者出现与环咽肌功能障碍相关的吞咽障碍。2例患者热损伤后出现持续数周的吞咽障碍。临床上，表现为液体和固体食物吞咽困难。电视荧光吞咽造影检查（VFSS）结果显示，咽食管括约肌（PES）松弛不佳、喉舌骨抬高降低以及咽部收缩不足。用20毫米扩张球囊导管多次扩张PES。术后吞咽障碍症状立即缓解。每隔1至2周进行4次球囊导管扩张。随访VFSS显示，PES松弛不佳的情况有所改善。在3个月的随访中，VFSS显示无复发。我们发现，球囊导管扩张术治疗热烧伤后环咽肌功能障碍患者有效、易用且安全。
