Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 10 , Pages 1346-1351, October 2006

Botulinum Toxin Type A for Poststroke Cricopharyngeal Muscle Dysfunction

  • Deog Young Kim, MD, PhD

      Affiliations

    • Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
    • ,
  • Chang-il Park, MD, PhD

      Affiliations

    • Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
    • ,
  • Suk Hoon Ohn, MD

      Affiliations

    • Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
    • Corresponding Author InformationReprint requests to Suk Hoon Ohn, MD, Rehabilitation Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752, South Korea
    • ,
  • Ja Young Moon, MD

      Affiliations

    • Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
    • ,
  • Won Hyuk Chang, MD, MS

      Affiliations

    • Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, South Korea
    • ,
  • Seung-woo Park, MD, PhD

      Affiliations

    • Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.

Abstract 

Kim DY, Park C, Ohn SH, Moon JY, Chang WH, Park S. Botulinum toxin type A for poststroke cricopharyngeal muscle dysfunction.

Objective

To evaluate the therapeutic effectiveness of botulinum toxin type A (BTX-A) in poststroke patients with cricopharyngeal muscle dysfunction.

Design

Before-after trial.

Setting

University hospital.

Participants

Eight poststroke patients.

Intervention

BTX-A injection into the cricopharyngeal muscle under endoscope guidance for poststroke cricopharyngeal muscle dysfunction.

Main Outcome Measures

Clinical symptom score, disability rating scale for swallowing impairment, videofluoroscopic swallowing study, and upper esophageal sphincter (UES) manometry.

Results

Clinical symptom score, disability rating scale for swallowing impairment, residue in piriform sinus, and UES pressure were all significantly improved at 2 weeks after BTX-A injection compared with evaluations before injection (P<.05). The effects on the clinical symptom score and disability rating scale for swallowing impairment continued to be significantly improved to 12 weeks after injection (P<.05). However, the residue in piriform sinus and the UES pressure at 12 weeks postinjection were reduced compared with before-injection evaluations; these results were not significant. The pharyngeal transit time was not changed after injection. There were no side effects observed in the patients studied.

Conclusions

The results of the present study suggest that BTX-A injection may be an effective and safe treatment in patients with poststroke cricopharyngeal muscle dysfunction.

Key Words: Botulinum toxin type A, Dysphagia, Pharyngeal muscles, Rehabilitation, Stroke

 

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(06)00724-6

doi:10.1016/j.apmr.2006.06.018

Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 10 , Pages 1346-1351, October 2006

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