title: Failure of cricopharyngeal myotomy to improve dysphagia following head and neck cancer surgery.
abstract: OBJECTIVE
  To determine whether cricopharyngeal myotomy can improve dysphagia associated with head and neck cancer surgery.
  
  
  METHODS
  Prospective, randomized, multicenter trial.
  
  
  METHODS
  Twelve clinical sites across the United States.
  
  
  METHODS
  Between 1989 and 1994, 125 patients undergoing combined modality therapy for head and neck cancer, including resection of the tongue base or supraglottic larynx, were prospectively entered into the trial.
  
  
  METHODS
  Cricopharyngeal myotomy on a randomized basis.
  
  
  METHODS
  Videofluoroscopic examination to determine oropharyngeal swallowing efficiency, which is defined as the ratio of percentage of the bolus swallowed to total swallowing time using 3 different bolus consistencies.
  
  
  RESULTS
  No significant difference in oropharyngeal swallowing efficiency between myotomy vs no myotomy was seen at 6 months of follow-up regardless of bolus consistency.
  
  
  CONCLUSIONS
  In this prospective test of cricopharyngeal myotomy, the procedure fails to significantly improve dysphagia associated with head and neck cancer surgery. The efficacy of this surgical procedure in other disease entities should also be rigorously explored.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, Mich 48201, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Jacobs
authors.forename: J
authors.initials: J
authors.lastname: Logemann
authors.forename: T F
authors.initials: TF
authors.lastname: Pajak
authors.forename: B R
authors.initials: BR
authors.lastname: Pauloski
authors.forename: S
authors.initials: S
authors.lastname: Collins
authors.forename: R R
authors.initials: RR
authors.lastname: Casiano
authors.forename: D E
authors.initials: DE
authors.lastname: Schuller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery*; D005260:Female; D005927:Glossectomy; D006801:Humans; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D010039:Otorhinolaryngologic Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D010609:Pharyngeal Muscles / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D016896:Treatment Outcome