Injection of botulinum toxin A to the upper esophageal sphincter for oropharyngeal dysphagia in two patients with inclusion body myositis.
Inclusion body myositis (IBM) is a progressive degenerative skeletal muscle disease leading to weakening and atrophy of both proximal and distal muscles. Dysphagia is reported in up to 86% of IBM patients. Surgical cricopharyngeal myotomy may be effective for cricopharyngeal dysphagia and there is one published report that botulinum toxin A, injected into the cricopharyngeus muscle using a hypopharyngoscope under general anesthesia, relieved IBM-associated dysphagia. This report presents the first documentation of botulinum toxin A injection into the upper esophageal sphincter using a flexible esophagogastroduodenoscope under conscious sedation, to reduce upper esophageal sphincter pressure and successfully alleviate oropharyngeal dysphagia in two IBM patients.
Liu
Louis W C
LW
Hamilton Health Sciences, Hamilton, Ontario, Canada. liuwc@mcmaster.ca
Tarnopolsky
Mark
M
Armstrong
David
D
D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D016292:Procedural Sedation; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D020776:Endoscopes, Gastrointestinal; D004943:Esophagogastric Junction / Q000503:physiopathology*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D018979:Myositis, Inclusion Body / Q000150:complications*; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D009960:Oropharynx / Q000503:physiopathology*; D011312:Pressure
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A