Partial Epiglottoplasty for Pharyngeal Dysphagia due to Cervical Spine Pathology.

Abstract

OBJECTIVE:

To examine the role of epiglottoplasty in patients with pharyngeal dysphagia due to pharyngeal crowding from cervical spine pathology and to assess swallowing outcomes following epiglottoplasty.

STUDY DESIGN:

Retrospective case series.

SETTING:

Academic tertiary care medical center.

SUBJECTS AND METHODS:

Dysphagia can occur in patients with cervical spine pathology because of hypopharyngeal crowding. Swallowing studies, such as modified barium swallow study and fiberoptic endoscopic evaluation of swallowing, may demonstrate a nonretroflexing epiglottis owing to cervical spine osteophytes or hardware, thus impeding pharyngeal bolus transit. We performed partial epiglottoplasties in a series of these patients. A retrospective review of swallowing outcomes was performed to assess the efficacy of this surgery in this patient population.

RESULTS:

Epiglottic dysfunction causing dysphagia due to cervical spine pathology was diagnosed by modified barium swallow study and/or fiberoptic endoscopic evaluation of swallowing in 12 patients. Findings included hypopharyngeal crowding because of cervical osteophytes (n = 8) or cervical hardware (n = 4) associated with absent epiglottic retroflexion and retained vallecular residue. Partial epiglottoplasty resulted in significant reduction of vallecular residue and a significant increase in functional swallow outcomes without an increase in swallow morbidity.

CONCLUSION:

There is a role for partial epiglottoplasty in patients with dysphagia attributed to hypopharyngeal crowding from cervical spine pathology. Surgery enables reduced vallecular residue and improved functional swallowing outcomes.

• Authors: Nausheen Jamal, Andrew Erman, Dinesh K Chhetri
• Journal: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 153 Issue 4 Pg. 586-92 (Oct 2015) ISSN: 1097-6817 [Electronic] England
• PMID: 26315313 (Publication Type: Clinical Study, Journal Article, Research Support, N.I.H., Extramural)
• Copyright: © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

Topics

• Aged
• Aged, 80 and over
• Cervical Vertebrae
• Deglutition Disorders (etiology, surgery)
• Epiglottis (surgery)
• Female
• Humans
• Male
• Middle Aged
• Osteophyte (complications)
• Otorhinolaryngologic Surgical Procedures (methods)
• Retrospective Studies
• Spinal Diseases (complications)