Center for Voice and Swallowing, Department of Otolaryngology-Head & Neck Surgery, Columbia University Irving Medical Center, New York, New York, U.S.A.
Department of Otolaryngology-Head & Neck Surgery, Istanbul Demiroglu Bilim University, Istanbul, Turkey.
Laryngoscope. 2024 Nov;134(11):4614-4619. doi: 10.1002/lary.31591. Epub 2024 Jun 19.
Retrograde Cricopharyngeal Dysfunction (RCPD) is treated by botulinum toxin (BTX) injection into the cricopharyngeus. This prospective study compares the effectiveness and side effects of operating room (OR) and in-office (IO) injections.
Patients over 18 years of age with inability to burp, abdominal, thoracic, or cervical gurgling sounds, bloating, and excessive flatulence were diagnosed with RCPD and included in the study. Injections were performed in the OR (80U) or IO (30U) by the senior author. An RCPD questionnaire quantifying major and minor symptoms on a Likert scale, Eating Assessment Tool-10 (EAT-10), and Generalized Anxiety Score-7 (GAD-7), were completed preinjection; at 1, 2, and 3 weeks; and 3 months postoperatively. Linear mixed models were used to analyze effects of BTX injection on RCPD symptoms, the EAT-10, and the GAD-7.
108 (55 M/53F) patients completed the pretreatment survey, 53 (31 OR vs. 22 IO) completed the 3-week follow-up, and 36 (22 OR vs. 14 IO) completed the 3-month questionnaire. Average posttreatment RCPD scores were significantly lower in both groups at 3 weeks and 3 months (p < 0.0001), There was no difference between IO or OR (p = 0.4924). GAD-7 scores were significantly lower in both groups at week 3 (p = 0.0018) and month 3 (p = 0.0012). Postinjection EAT-10 scores were significantly higher in OR compared with IO (p = 0.0379).
OR and IO injections are equally effective in the treatment of RCPD. Postinjection dysphagia is more severe after the OR injections which may be related to higher doses of BTX used. General anxiety levels decrease with treatment.
2 Laryngoscope, 134:4614-4619, 2024.
通过向环咽肌注射肉毒毒素（BTX）来治疗逆行性环咽肌功能障碍（RCPD）。本前瞻性研究比较了手术室（OR）和门诊（IO）注射的效果和副作用。
对年龄在 18 岁以上、无法打嗝、出现腹部、胸部或颈部咕噜声、腹胀和过度嗳气的患者进行 RCPD 诊断，并纳入本研究。由资深作者在 OR（80U）或 IO（30U）进行注射。注射前、注射后 1、2 和 3 周以及 3 个月时，使用 RCPD 问卷对主要和次要症状进行定量评估（Likert 量表）、进食评估工具-10 分（EAT-10）和广泛性焦虑评分-7 分（GAD-7）。使用线性混合模型分析 BTX 注射对 RCPD 症状、EAT-10 和 GAD-7 的影响。
108 名（55 名男性/53 名女性）患者完成了预处理调查，53 名（31 名 OR 与 22 名 IO）完成了 3 周随访，36 名（22 名 OR 与 14 名 IO）完成了 3 个月问卷。两组患者在注射后 3 周和 3 个月时的平均 RCPD 评分均显著降低（p<0.0001），但 OR 和 IO 之间没有差异（p=0.4924）。两组患者在第 3 周（p=0.0018）和第 3 个月（p=0.0012）时的 GAD-7 评分均显著降低。OR 组患者注射后 EAT-10 评分显著高于 IO 组（p=0.0379）。
OR 和 IO 注射在治疗 RCPD 方面同样有效。OR 注射后吞咽困难更严重，这可能与使用的 BTX 剂量较高有关。治疗后，总体焦虑水平降低。
2 级喉镜检查，134：4614-4619，2024.
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