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Efficacy of fluoroscopy-guided endoscopic cricopharyngeal myotomy

Published online by Cambridge University Press:  24 January 2019

K Fujiwara ,
K Kawamoto ,
K Taira ,
T Fukuhara ,
S Koyama ,
H Kataoka ,
H Kitano  and
H Takeuchi
K Fujiwara*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
K Kawamoto
Affiliation:
Department of Otolaryngology, Head and Neck Thyroid Surgery, Kusatsu General Hospital, Japan
K Taira
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
T Fukuhara
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
S Koyama
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
H Kataoka
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
H Kitano
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
H Takeuchi
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
*
Author for correspondence: Dr Kazunori Fujiwara, Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, 36-1 Nishimachi, Yonago 683-8504, Japan E-mail: kfujiwa@med.tottori-u.ac.jp Fax: +81 859 38 6629
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Abstract

Background

In endoscopic cricopharyngeal myotomy, surgeons sometimes have concerns about performing an adequate incision with only a narrow intra-cavital view from one direction. In order to overcome these issues, fluoroscopic radiography was used during endoscopic cricopharyngeal myotomy.

Methods

Peri-operative fluoroscopic radiography was utilised to check the position of the diverticuloscope, and to confirm the extent of the incision during surgery. A balloon catheter was used to determine whether the cricopharyngeal muscle was sufficiently resected. Blood loss, peri-operative complications, and functional oral swallowing scale and penetration aspiration scale scores were evaluated.

Results

In 12 out of 15 patients, intra-operative fluoroscopic radiography showed the diverticuloscope positioned in the post-cricoid area, and the cricopharyngeal muscle was raised and the surgery completed without adverse effect. Swallowing functions improved following surgery.

Conclusion

Intra-operative fluoroscopy might improve endoscopic cricopharyngeal myotomy by allowing surgeons to confirm the extent of resection, and by reducing peri-operative morbidity and complication rates.

Keywords

Endoscopic Cricopharyngeal MyotomyIntraoperative Fluoroscopic ImagingBalloon CatheterFunctional Oral Swallowing ScalePenetration Aspiration ScaleDysphagia
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 12 , December 2018 , pp. 1128 - 1133
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr K Fujiwara takes responsibility for the integrity of the content of the paper

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