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Article: Office-based cricopharyngeus balloon dilation for post chemoirradiation dysphagia in nasopharyngeal carcinoma patients: A pilot study

TitleOffice-based cricopharyngeus balloon dilation for post chemoirradiation dysphagia in nasopharyngeal carcinoma patients: A pilot study
Authors
KeywordsNasopharyngeal carcinoma
Dilation
Swallowing treatment
Cricopharyngeal dysfunction
Deglutition
Issue Date2019
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00455/
Citation
Dysphagia, 2019, v. 34 n. 4, p. 540-547 How to Cite?
AbstractDysphagia is a common sequela post chemo/radiotherapy for nasopharyngeal carcinoma (NPC), with cricopharyngeal dysfunction often a contributing factor. This study examined the impact of balloon dilation of the cricopharyngeus and cervical oesophagus on swallow competence for dysphagic patients with cricopharyngeal dysfunction post NPC. Patients with NPC were screened for dysphagia and cricopharyngeal dysfunction using fiberoptic endoscopic evaluation. Thirteen symptomatic patients, median 14.1 years post chemoradiotherapy for NPC, then underwent balloon dilation under local anesthesia. Before and 1 month post dilation, swallow function was assessed with fluoroscopy, and rated using the penetration–aspiration scale, temporal swallowing measures, and MBSImP pharyngoesophageal segment opening and esophageal clearance parameter. The MD Anderson Dysphagia Inventory (MDADI; Chinese version) and the Functional Oral Intake Scale (FOIS) were collected pre-, 1 month, and approximately 3 months post dilation. Post-dilation, significant improvements were noted in mean FOIS scores (5.00 to 5.62), duration of cricopharyngeus opening (0.42 s to 0.53 s), MBSImP pharyngoesophageal opening scores (1.61 to 1.08), penetration-aspiration scale scores (4.85 to 3.92) and MDADI Composite score (46.48 to 52.43). At 3 months post dilation, the MDADI Composite Score showed sustained benefit. The procedure was well tolerated and without complication. In patients with cricopharyngeal dysfunction post NPC, balloon dilation significantly improved swallow function, reduced aspiration risk and improved quality of life. Evidence from a larger cohort with long-term follow-up is warranted to determine sustained benefit.
Persistent Identifierhttp://hdl.handle.net/10722/272998
ISSN
2019 Impact Factor: 2.591
2015 SCImago Journal Rankings: 0.660

 

DC FieldValueLanguage
dc.contributor.authorFong, R-
dc.contributor.authorSun, N-
dc.contributor.authorNg, YW-
dc.contributor.authorRumbach, AF-
dc.contributor.authorWard, EC-
dc.contributor.authorTsang, R-
dc.date.accessioned2019-08-06T09:20:39Z-
dc.date.available2019-08-06T09:20:39Z-
dc.date.issued2019-
dc.identifier.citationDysphagia, 2019, v. 34 n. 4, p. 540-547-
dc.identifier.issn0179-051X-
dc.identifier.urihttp://hdl.handle.net/10722/272998-
dc.description.abstractDysphagia is a common sequela post chemo/radiotherapy for nasopharyngeal carcinoma (NPC), with cricopharyngeal dysfunction often a contributing factor. This study examined the impact of balloon dilation of the cricopharyngeus and cervical oesophagus on swallow competence for dysphagic patients with cricopharyngeal dysfunction post NPC. Patients with NPC were screened for dysphagia and cricopharyngeal dysfunction using fiberoptic endoscopic evaluation. Thirteen symptomatic patients, median 14.1 years post chemoradiotherapy for NPC, then underwent balloon dilation under local anesthesia. Before and 1 month post dilation, swallow function was assessed with fluoroscopy, and rated using the penetration–aspiration scale, temporal swallowing measures, and MBSImP pharyngoesophageal segment opening and esophageal clearance parameter. The MD Anderson Dysphagia Inventory (MDADI; Chinese version) and the Functional Oral Intake Scale (FOIS) were collected pre-, 1 month, and approximately 3 months post dilation. Post-dilation, significant improvements were noted in mean FOIS scores (5.00 to 5.62), duration of cricopharyngeus opening (0.42 s to 0.53 s), MBSImP pharyngoesophageal opening scores (1.61 to 1.08), penetration-aspiration scale scores (4.85 to 3.92) and MDADI Composite score (46.48 to 52.43). At 3 months post dilation, the MDADI Composite Score showed sustained benefit. The procedure was well tolerated and without complication. In patients with cricopharyngeal dysfunction post NPC, balloon dilation significantly improved swallow function, reduced aspiration risk and improved quality of life. Evidence from a larger cohort with long-term follow-up is warranted to determine sustained benefit.-
dc.languageeng-
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00455/-
dc.relation.ispartofDysphagia-
dc.rightsThis is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: http://dx.doi.org/[insert DOI]-
dc.subjectNasopharyngeal carcinoma-
dc.subjectDilation-
dc.subjectSwallowing treatment-
dc.subjectCricopharyngeal dysfunction-
dc.subjectDeglutition-
dc.titleOffice-based cricopharyngeus balloon dilation for post chemoirradiation dysphagia in nasopharyngeal carcinoma patients: A pilot study-
dc.typeArticle-
dc.identifier.emailTsang, R: rkytsang@hku.hk-
dc.identifier.authorityTsang, R=rp01386-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00455-019-10002-3-
dc.identifier.pmid30888528-
dc.identifier.scopuseid_2-s2.0-85063213310-
dc.identifier.hkuros300936-
dc.identifier.volume34-
dc.identifier.issue4-
dc.identifier.spage540-
dc.identifier.epage547-
dc.publisher.placeUnited States-

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