Outcomes of endoscopic cricopharyngeal myotomy with CO2 laser surgery: A retrospective study of 47 patients

Head Neck. 2016 Jul;38(7):1022-7. doi: 10.1002/hed.24400. Epub 2016 Feb 13.

Abstract

Background: Endoscopic cricopharyngeal myotomy (ECPM) using CO2 laser surgery presents a less invasive treatment technique when compared to transcervical cricopharyngeal myotomy.

Methods: Forty-seven patients who underwent ECPM from 2002 until 2013 were included in this study. Patient characteristics, and preoperative and postoperative outcome and complications were scored by retrospective chart review and by using the Deglutition Handicap Index (DHI).

Results: Overall, 40 of 47 patients (85%) experienced relief of symptoms postoperatively. Ten patients (25%) developed recurrent symptoms of dysphagia requiring re-laser surgery. All 40 patients were satisfied at the postoperative visit after an average of 1.3 interventions. DHI scores were better in patients with idiopathic dysfunction and neurologic disease, compared to dysfunction because of prior treatment of head and neck cancer. One patient developed mediastinitis that was successfully treated with antibiotics. There was no mortality.

Conclusion: ECPM is an effective treatment for cricopharyngeal dysfunction with a low rate of surgical morbidity and complications. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1022-1027, 2016.

Keywords: complications; cricopharyngeal dysfunction; endoscopic cricopharyngeal myotomy; indication; outcome.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carbon Dioxide / therapeutic use
  • Cohort Studies
  • Cricoid Cartilage / surgery
  • Deglutition Disorders / etiology
  • Deglutition Disorders / surgery*
  • Endoscopy / methods
  • Female
  • Hospitals, University
  • Humans
  • Laser Therapy / methods*
  • Lasers, Gas / therapeutic use*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Myotomy / methods*
  • Patient Satisfaction / statistics & numerical data
  • Pharyngeal Muscles / physiopathology
  • Quality of Life*
  • Recurrence
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome

Substances

  • Carbon Dioxide