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Evaluation of upper oesophageal sphincter in unilateral vocal fold paralysis

Published online by Cambridge University Press:  01 February 2019

O Erdur ,
O Gul  and
K Ozturk
O Erdur*
Affiliation:
Department of Otolaryngology, Selcuk University Medical Faculty Hospital, Konya, Turkey
O Gul
Affiliation:
Department of Otolaryngology, Selcuk University Medical Faculty Hospital, Konya, Turkey
K Ozturk
Affiliation:
Department of Otolaryngology, Selcuk University Medical Faculty Hospital, Konya, Turkey
*
Author for correspondence: Dr Omer Erdur, Selcuk University Medical Faculty Hospital, Alaeddin Keykubad Campus, 42075 Yeni Istanbul Caddesi, Konya, Turkey E-mail: dromerdur@yahoo.com
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Abstract

Objective

To evaluate dysphagia and manometric changes in the upper oesophageal sphincter in patients with unilateral vocal fold paralysis.

Methods

Thirty patients with unilateral vocal fold paralysis due to vagal nerve paralysis scheduled for evaluation were enrolled in the study group; 24 healthy subjects were included in the control group. Upper oesophageal sphincter basal and residual pressure, relaxation time, and pharyngeal pressure values were evaluated by manometry. All patients completed the Turkish Eating Assessment Tool 10 questionnaire, the MD Anderson dysphagia questionnaire and the reflux symptom index form.

Results

Swallowing assessment questionnaires and reflux symptom index results were significantly higher in the study group. Upper oesophageal sphincter basal and relaxation pressures were lower in the study group. Upper oesophageal sphincter relaxation time was shorter in the study group, but pressure values recorded from the pharynx were higher.

Conclusion

Upper oesophageal sphincter manometric pressure was lower in patients with unilateral vocal fold paralysis. A hypotonic sphincter likely contributes to dysphagia and aspiration.

Keywords

Unilateral Vocal Cord ParalysisAspiration, RespiratoryDysphagiaManometryUpper Esophageal Sphincter

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 2 , February 2019 , pp. 149 - 154
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr O Erdur takes responsibility for the integrity of the content of the paper

References

1Behrman, A. Evidence-based treatment of paralytic dysphonia: making sense of outcomes and efficacy data. Otolaryngol Clin North Am 2004;37:75–104Google Scholar
2Asik, MB, Karasimav, O, Birkent, H, Merati, AL, Gerek, M, Yildiz, Y. Airway and respiration parameters improve following vocal fold medialization: a prospective study. Ann Otol Rhinol Laryngol 2015;124:972–7Google Scholar
3Spector, BC, Netterville, JL, Billante, C, Clary, J, Reinisch, L, Smith, TL. Quality-of-life assessment in patients with unilateral vocal cord paralysis. Otolaryngol Head Neck Surg 2001;125:176–82Google Scholar
4Nayak, VK, Bhattacharyya, N, Kotz, T, Shapiro, J. Patterns of swallowing failure following medialization in unilateral vocal fold immobility. Laryngoscope 2002;112:1840–4Google Scholar
5Cates, DJ, Venkatesan, NN, Strong, B, Kuhn, MA, Belafsky, PC. Effect of vocal fold medialization on dysphagia in patients with unilateral vocal fold immobility. Otolaryngol Head Neck Surg 2016;155:454–7Google Scholar
6Leder, SB, Suiter, DM, Duffey, D, Judson, BL. Vocal fold immobility and aspiration status: a direct replication study. Dysphagia 2012;27:265–70Google Scholar
7Jang, YY, Lee, SJ, Jeon, JY, Lee, SJ. Analysis of video fluoroscopic swallowing study in patients with vocal cord paralysis. Dysphagia 2012;27:185–90Google Scholar
8Leder, SB, Ross, DA. Incidence of vocal fold immobility in patients with dysphagia. Dysphagia 2005;20:163–9Google Scholar
9Tabaee, A, Murry, T, Zschommler, A, Desloge, RB. Flexible endoscopic evaluation of swallowing with sensory testing in patients with unilateral vocal fold immobility: incidence and pathophysiology of aspiration. Laryngoscope 2005;115:565–9Google Scholar
10Domer, AS, Leonard, R, Belafsky, PC. Pharyngeal weakness and upper esophageal sphincter opening in patients with unilateral vocal fold immobility. Laryngoscope 2014;124:2371–4Google Scholar
11Sasaki, CT, Kim, YH, Stevenson, H, Czibulka, A. Motor innervation of the human cricopharyngeus muscle. Ann Otol Rhinol Laryngol 1999;108:1132–9Google Scholar
12Mu, L, Sanders, I. The innervation of the human upper esophageal sphincter. Dysphagia 1996;11:234–8Google Scholar
13Hila, A, Castell, JA, Castell, DO. Pharyngeal and upper esophageal sphincter manometry in the evaluation of dysphagia. J Clin Gastroenterol 2001;33:355–61Google Scholar
14Herbella, FA, Patti, MG. Can high resolution manometry parameters for achalasia be obtained by conventional manometry? World J Gastrointest Pathophysiol 2015;6:58–61Google Scholar
15Demir, N, Arslan, SS, Karaduman, AA. Reliability and validity of the Turkish Eating Assessment Tool (T-EAT-10). Dysphagia 2016;31:644–9Google Scholar
16Belafsky, PC, Postma, GN, Koufman, JA. Laryngopharyngeal reflux symptoms improve before changes in physical findings. Laryngoscope 2001;111:979–81Google Scholar
17Bhattacharyya, N, Kotz, T, Shapiro, J. Dysphagia and aspiration with unilateral vocal cord immobility: incidence, characterization, and response to surgical treatment. Ann Otol Rhinol Laryngol 2002;111:672–9Google Scholar
18Henderson, RD, Boszko, A, VanNostrand, AW, Pearson, FG. Pharyngoesophageal dysphagia and recurrent laryngeal nerve palsy. J Thorac Cardiovasc Surg 1974;68:507–12Google Scholar
19Wilson, JA, Pryde, A, White, A, Maher, L, Maran, AG. Swallowing performance in patients with vocal fold motion impairment. Dysphagia 1995;10:149–54Google Scholar
20Pinna, BR, Herbella, FAM, de Biase, N, Vaiano, TCG, Patti, MG. High-resolution manometry evaluation of pressures at the pharyngo-upper esophageal area in patients with oropharyngeal dysphagia due to vagal paralysis. Dysphagia 2017;32:657–62Google Scholar
21Nativ-Zeltzer, N, Logemann, JA, Zecker, SG, Kahrilas, PJ. Pressure topography metrics for high resolution pharyngeal esophageal manofluorography—a normative study of younger and older adults. Neurogastroenterol Motil 2016;28:721–31Google Scholar
22Leonard, R, Rees, CJ, Belafsky, P, Allen, J. Fluoroscopic surrogate for pharyngeal strength: the pharyngeal constriction ratio (PCR). Dysphagia 2011;26:13–17Google Scholar
23Bhatia, SJ, Shah, C. How to perform and interpret upper esophageal sphincter manometry. J Neurogastroenterol Motil 2013;19:99–103Google Scholar