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Surgery for Swallowing Disorders

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Textbook of Surgery of Larynx and Trachea
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Abstract

Dysphagia describes difficulty with swallowing and is a symptom of many disorders and diseases of the oral cavity, pharynx, larynx, and esophagus. Dysphagia has a profound effect on quality of life, and otolaryngologists play a valuable role in a multispecialty, team-based approach to dysphagia management. This chapter provides a fundamental knowledge base for the evaluation and surgical treatment of dysphagia, highlighting aspiration, cricopharyngeus muscle dysfunction, gastroesophageal reflux disease, obstructive esophageal pathology, cervical diverticula, and motility disorders.

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References

  1. Cho SY, Choung RS, Saito YA, et al. Prevalence and risk factors for dysphagia: a USA community study. Neurogastroenterol Motil. 2015;27:212–9.

    CAS  PubMed  Google Scholar 

  2. Jones E, Speyer R, Kertscher B, et al. Health-related quality of life and oropharyngeal dysphagia: a systematic review. Dysphagia. 2018;33:141–72.

    PubMed  Google Scholar 

  3. Altman KW, Yu GP, Schaefer SD. Consequence of dysphagia in the hospitalized patient: impact on prognosis and hospital resources. Arch Otolaryngol Head Neck Surg. 2010;136:784–9.

    PubMed  Google Scholar 

  4. Ashraf HH, Palmer J, Dalton HR, et al. Can patients determine the level of their dysphagia? World J Gastroenterol. 2017;23:1038–43.

    PubMed  PubMed Central  Google Scholar 

  5. Wilcox CM, Alexander LN, Clark WS. Localization of an obstructing esophageal lesion. Is the patient accurate? Dig Dis Sci. 1995;40:2192–6.

    CAS  PubMed  Google Scholar 

  6. Bastian RW. The videoendoscopic swallowing study: an alternative and partner to the videofluoroscopic swallowing study. Dysphagia. 1993;8:359–67.

    CAS  PubMed  Google Scholar 

  7. Hiss SG, Postma GN. Fiberoptic endoscopic evaluation of swallowing. Laryngoscope. 2003;113:1386–93.

    PubMed  Google Scholar 

  8. Belafsky PC, Kuhn MA. The clinician’s guide to swallowing fluoroscopy. New York: Springer; 2014.

    Google Scholar 

  9. Postma GN, Cohen JT, Belafsky PC, et al. Transnasal esophagoscopy: revisited (over 700 consecutive cases). Laryngoscope. 2005;115:321–3.

    PubMed  Google Scholar 

  10. Jobe BA, Hunter JG, Chang EY, et al. Office-based unsedated small-caliber endoscopy is equivalent to conventional sedated endoscopy in screening and surveillance for Barrett’s esophagus: a randomized and blinded comparison. Am J Gastroenterol. 2006;101:2693–703.

    PubMed  Google Scholar 

  11. Allen JE, White CJ, Leonard RJ, Belafsky PC. Prevalence of penetration and aspiration on videofluoroscopy in normal individuals without dysphagia. Otolaryngol Head Neck Surg. 2010;142:208–13.

    PubMed  Google Scholar 

  12. Butler SG, Stuart A, Markley L, Rees C. Penetration and aspiration in healthy older adults as assessed during endoscopic evaluation of swallowing. Ann Otol Rhinol Laryngol. 2009;118:190–8.

    PubMed  Google Scholar 

  13. Santoso LF, Kim DY, Paydarfar D. Sensory dysphagia: a case series and proposed classification of an under recognized swallowing disorder. Head Neck. 2019;41:E71–8.

    PubMed  Google Scholar 

  14. Kaneoka A, Pisegna JM, Inokuchi H, et al. Relationship between laryngeal sensory deficits, aspiration, and pneumonia in patients with dysphagia. Dysphagia. 2018;33:192–9.

    PubMed  Google Scholar 

  15. Aviv JE, Spitzer J, Cohen M, et al. Laryngeal adductor reflex and pharyngeal squeeze as predictors of laryngeal penetration and aspiration. Laryngoscope. 2002;112:338–41.

    PubMed  Google Scholar 

  16. Leder SB, Sasaki CT, Burrell MI. Fiberoptic endoscopic evaluation of dysphagia to identify silent aspiration. Dysphagia. 1998;13:19–21.

    CAS  PubMed  Google Scholar 

  17. Holas MA, DePippo KL, Reding MJ. Aspiration and relative risk of medical complications following stroke. Arch Neurol. 1994;51:1051–3.

    CAS  PubMed  Google Scholar 

  18. Leder SB. Fiberoptic endoscopic evaluation of swallowing in patients with acute traumatic brain injury. J Head Trauma Rehabil. 1999;14:448–53.

    CAS  PubMed  Google Scholar 

  19. Yiu Y, Curtis JA, Perry SE, Troche MS. Relationship of vocal fold atrophy to swallowing safety and cough function in Parkinson’s disease. Laryngoscope. 2020;130:303–8.

    PubMed  Google Scholar 

  20. Zhou D, Jafri M, Husain I. Identifying the prevalence of dysphagia among patients diagnosed with unilateral vocal fold immobility. Otolaryngol Head Neck Surg. 2019;160:955–64.

    PubMed  Google Scholar 

  21. Bhattacharyya N, Batirel H, Swanson SJ. Improved outcomes with early vocal fold medialization for vocal fold paralysis after thoracic surgery. Auris Nasus Larynx. 2003;30:71–5.

    PubMed  Google Scholar 

  22. Dion GR, Achlatis E, Teng S, et al. Changes in peak airflow measurement during maximal cough after vocal fold augmentation in patients with glottic insufficiency. JAMA Otolaryngol Head Neck Surg. 2017;143:1141–5.

    PubMed  PubMed Central  Google Scholar 

  23. Reder L, Bertelsen C, Angajala V, et al. Hospitalized patients with new-onset vocal fold immobility warrant inpatient injection laryngoplasty. Laryngoscope. 2020;

    Google Scholar 

  24. Kos MP, David EF, Aalders IJ, et al. Long-term results of laryngeal suspension and upper esophageal sphincter myotomy as treatment for life-threatening aspiration. Ann Otol Rhinol Laryngol. 2008;117:574–80.

    PubMed  Google Scholar 

  25. Tomioka H, Yamashita S, Mamesaya N, Kaneko M. Percutaneous endoscopic gastrostomy for aspiration pneumonia: a 10-year single-center experience. Respir Investig. 2017;55:203–11.

    PubMed  Google Scholar 

  26. Theunissen EA, Timmermans AJ, Zuur CL, et al. Total laryngectomy for a dysfunctional larynx after (chemo)radiotherapy. Arch Otolaryngol Head Neck Surg. 2012;138:548–55.

    PubMed  Google Scholar 

  27. Topf MC, Magana LC, Salmon K, et al. Safety and efficacy of functional laryngectomy for end-stage dysphagia. Laryngoscope. 2018;128:597–602.

    PubMed  Google Scholar 

  28. Sivarao DV, Goyal RK. Functional anatomy and physiology of the upper esophageal sphincter. Am J Med. 2000;108(Suppl 4a):27S–37S.

    PubMed  Google Scholar 

  29. Leaper M, Zhang M, Dawes PJ. An anatomical protrusion exists on the posterior hypopharyngeal wall in some elderly cadavers. Dysphagia. 2005;20:8–14.

    PubMed  Google Scholar 

  30. Leonard R, Kendall K, McKenzie S. UES opening and cricopharyngeal bar in nondysphagic elderly and nonelderly adults. Dysphagia. 2004;19:182–91.

    PubMed  Google Scholar 

  31. Dantas RO, Cook IJ, Dodds WJ, et al. Biomechanics of cricopharyngeal bars. Gastroenterology. 1990;99:1269–74.

    CAS  PubMed  Google Scholar 

  32. Schneider I, Thumfart WF, Pototschnig C, Eckel HE. Treatment of dysfunction of the cricopharyngeal muscle with botulinum a toxin: introduction of a new, noninvasive method. Ann Otol Rhinol Laryngol. 1994;103:31–5.

    CAS  PubMed  Google Scholar 

  33. Rees CJ, Fordham T, Belafsky PC. Transnasal balloon dilation of the esophagus. Arch Otolaryngol Head Neck Surg. 2009;135:781–3.

    PubMed  Google Scholar 

  34. Clary MS, Daniero JJ, Keith SW, et al. Efficacy of large-diameter dilatation in cricopharyngeal dysfunction. Laryngoscope. 2011;121:2521–5.

    PubMed  Google Scholar 

  35. Randall DR, Evangelista LM, Kuhn MA, Belafsky PC. Improved symptomatic, functional, and fluoroscopic outcomes following serial “series of three” double-balloon dilation for cricopharyngeus muscle dysfunction. J Otolaryngol Head Neck Surg. 2018;47:35.

    PubMed  PubMed Central  Google Scholar 

  36. Kelly EA, Koszewski IJ, Jaradeh SS, et al. Botulinum toxin injection for the treatment of upper esophageal sphincter dysfunction. Ann Otol Rhinol Laryngol. 2013;122:100–8.

    PubMed  PubMed Central  Google Scholar 

  37. Kim MS, Kim GW, Rho YS, et al. Office-based electromyography-guided botulinum toxin injection to the cricopharyngeus muscle: optimal patient selection and technique. Ann Otol Rhinol Laryngol. 2017;126:349–56.

    PubMed  Google Scholar 

  38. Kocdor P, Siegel ER, Tulunay-Ugur OE. Cricopharyngeal dysfunction: a systematic review comparing outcomes of dilatation, botulinum toxin injection, and myotomy. Laryngoscope. 2016;126:135–41.

    CAS  PubMed  Google Scholar 

  39. Perie S, Eymard B, Laccourreye L, et al. Dysphagia in oculopharyngeal muscular dystrophy: a series of 22 French cases. Neuromuscul Disord. 1997;7(Suppl 1):S96–9.

    PubMed  Google Scholar 

  40. El-Serag HB, Petersen NJ, Carter J, et al. Gastroesophageal reflux among different racial groups in the United States. Gastroenterology. 2004;126:1692–9.

    PubMed  Google Scholar 

  41. Bollschweiler E, Knoppe K, Wolfgarten E, Holscher AH. Prevalence of dysphagia in patients with gastroesophageal reflux in Germany. Dysphagia. 2008;23:172–6.

    PubMed  Google Scholar 

  42. Vakil NB, Traxler B, Levine D. Dysphagia in patients with erosive esophagitis: prevalence, severity, and response to proton pump inhibitor treatment. Clin Gastroenterol Hepatol. 2004;2:665–8.

    CAS  PubMed  Google Scholar 

  43. Hershcovici T, Mashimo H, Fass R. The lower esophageal sphincter. Neurogastroenterol Motil. 2011;23:819–30.

    CAS  PubMed  Google Scholar 

  44. El-Serag H, Becher A, Jones R. Systematic review: persistent reflux symptoms on proton pump inhibitor therapy in primary care and community studies. Aliment Pharmacol Ther. 2010;32:720–37.

    CAS  PubMed  Google Scholar 

  45. Oda K, Iwakiri R, Hara M, et al. Dysphagia associated with gastroesophageal reflux disease is improved by proton pump inhibitor. Dig Dis Sci. 2005;50:1921–6.

    CAS  PubMed  Google Scholar 

  46. Wetscher GJ, Glaser K, Gadenstaetter M, et al. The effect of medical therapy and antireflux surgery on dysphagia in patients with gastroesophageal reflux disease without esophageal stricture. Am J Surg. 1999;177:189–92.

    CAS  PubMed  Google Scholar 

  47. Mehdizadeh OB, Wickwire P, Said M, Belafsky PC. The prevalence of cricopharyngeal webs in elderly cadavers. Laryngoscope. 2019;129:63–6.

    PubMed  Google Scholar 

  48. Josino IR, Madruga-Neto AC, Ribeiro IB, et al. Endoscopic dilation with bougies versus balloon dilation in esophageal benign strictures: systematic review and meta-analysis. Gastroenterol Res Pract. 2018;2018:5874870.

    PubMed  PubMed Central  Google Scholar 

  49. Maple JT, Petersen BT, Baron TH, et al. Endoscopic management of radiation-induced complete upper esophageal obstruction with an antegrade-retrograde rendezvous technique. Gastrointest Endosc. 2006;64:822–8.

    PubMed  Google Scholar 

  50. Choong CK, Meyers BF. Benign esophageal tumors: introduction, incidence, classification, and clinical features. Semin Thorac Cardiovasc Surg. 2003;15:3–8.

    PubMed  Google Scholar 

  51. Codipilly DC, Qin Y, Dawsey SM, et al. Screening for esophageal squamous cell carcinoma: recent advances. Gastrointest Endosc. 2018;88:413–26.

    PubMed  PubMed Central  Google Scholar 

  52. Howell RJ, Giliberto JP, Harmon J, et al. Open versus endoscopic surgery of Zenker’s diverticula: a systematic review and meta-analysis. Dysphagia. 2019;34:930–8.

    PubMed  Google Scholar 

  53. Crawley B, Dehom S, Tamares S, et al. Adverse events after rigid and flexible endoscopic repair of Zenker’s diverticula: a systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2019;161:388–400.

    PubMed  Google Scholar 

  54. Verdonck J, Morton RP. Systematic review on treatment of Zenker’s diverticulum. Eur Arch Otorhinolaryngol. 2015;272:3095–107.

    PubMed  Google Scholar 

  55. Allen J, Blair D, Miles A. Assessment of videofluoroscopic swallow study findings before and after cricopharyngeal myotomy. Head Neck. 2017;39:1869–75.

    PubMed  Google Scholar 

  56. Haddad N, Agarwal P, Levi JR, et al. Presentation and management of Killian Jamieson diverticulum: a comprehensive literature review. Ann Otol Rhinol Laryngol. 2020;129:394–400.

    PubMed  Google Scholar 

  57. Johnson CM, Postma GN. Not all pharyngeal pouches are created equal: management of “non-zenker” hypopharyngeal diverticula. Oper Tech Otolayngol Head Neck Surg. 2016;27:80–5.

    Google Scholar 

  58. Howell RJ, Edelmayer LW, Postma GN. The utility of flexible esophagoscopy during open hypopharyngeal (Zenker’s) diverticulum surgery. Laryngoscope. 2019;

    Google Scholar 

  59. Kahrilas PJ, Bredenoord AJ, Fox M, et al. The Chicago classification of esophageal motility disorders, v3.0. Neurogastroenterol Motil. 2015;27:160–74.

    CAS  PubMed  Google Scholar 

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Correspondence to Zao M. Yang .

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Yang, Z.M., Postma, G.N. (2022). Surgery for Swallowing Disorders. In: Remacle, M., Eckel, H.E. (eds) Textbook of Surgery of Larynx and Trachea. Springer, Cham. https://doi.org/10.1007/978-3-031-09621-1_34

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  • DOI: https://doi.org/10.1007/978-3-031-09621-1_34

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-09620-4

  • Online ISBN: 978-3-031-09621-1

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