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- Publisher Website: 10.1016/j.oraloncology.2020.104612
- Scopus: eid_2-s2.0-85080052298
- PMID: 32135435
- WOS: WOS:000529351800023
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Article: Swallowing disorders following free jejunal flap reconstruction of circumferential pharyngeal defect: Does Botox help?
Title | Swallowing disorders following free jejunal flap reconstruction of circumferential pharyngeal defect: Does Botox help? |
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Authors | |
Keywords | Swallowing Swallowing disorder Swallowing dysfunction Free jejunal flap Circumferential pharyngectomy |
Issue Date | 2020 |
Publisher | Pergamon. The Journal's web site is located at http://www.elsevier.com/locate/oraloncology |
Citation | Oral Oncology, 2020, v. 104, p. article no. 104612 How to Cite? |
Abstract | Objectives:
Free jejunal flap for circumferential pharyngeal reconstruction is associated with late-onset dysphagia, regurgitation and prolonged transit time. This study aims to assess the feasibility and efficacy of Botulinum toxin A (Botox) in alleviating such swallowing dysfunction.
Materials and methods:
Twenty-six consecutive patients underwent free jejunal flap for circumferential pharyngeal reconstruction between January 2012 and December 2018. Outcomes were compared at 6, 12 and 24 months.
Results:
In the non-Botox group (n = 13), video-fluoroscopic and manometry studies demonstrated asynchronous contractions and retrograde propulsion. All patients complained of nasal regurgitation on thin fluids at 6, 12 and 24 months. Bolus residue accumulation along jejunal mucosal folds resulted in prolonged transit time. In the Botox group (n = 13), amplitude of asynchronous contractions were lower: 25.4 mmHg vs. 52.1 mmHg (p = 0.037) for thin fluids at 12 months. Three patients complained of nasal regurgitation on thin fluids at 6 months. All 3 were asymptomatic at 12 months. Transit time was shortened overall. Functional Oral Intake Scale was higher. MD Anderson Dysphagia Inventory global (72.5% vs 45.7%, p = 0.003) and functional (62.0% vs 40.6%, p = 0.012) subscales were significantly improved at 24 months.
Conclusion:
Botox safely and effectively alleviates swallowing dysfunction associated with free jejunal flap for circumferential pharyngeal reconstruction. |
Persistent Identifier | http://hdl.handle.net/10722/284614 |
ISSN | 2021 Impact Factor: 5.972 2020 SCImago Journal Rankings: 1.623 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chow, VLY | - |
dc.contributor.author | Chan, JYW | - |
dc.contributor.author | Cheng, IKY | - |
dc.contributor.author | Chan, KMK | - |
dc.date.accessioned | 2020-08-07T09:00:10Z | - |
dc.date.available | 2020-08-07T09:00:10Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Oral Oncology, 2020, v. 104, p. article no. 104612 | - |
dc.identifier.issn | 1368-8375 | - |
dc.identifier.uri | http://hdl.handle.net/10722/284614 | - |
dc.description.abstract | Objectives: Free jejunal flap for circumferential pharyngeal reconstruction is associated with late-onset dysphagia, regurgitation and prolonged transit time. This study aims to assess the feasibility and efficacy of Botulinum toxin A (Botox) in alleviating such swallowing dysfunction. Materials and methods: Twenty-six consecutive patients underwent free jejunal flap for circumferential pharyngeal reconstruction between January 2012 and December 2018. Outcomes were compared at 6, 12 and 24 months. Results: In the non-Botox group (n = 13), video-fluoroscopic and manometry studies demonstrated asynchronous contractions and retrograde propulsion. All patients complained of nasal regurgitation on thin fluids at 6, 12 and 24 months. Bolus residue accumulation along jejunal mucosal folds resulted in prolonged transit time. In the Botox group (n = 13), amplitude of asynchronous contractions were lower: 25.4 mmHg vs. 52.1 mmHg (p = 0.037) for thin fluids at 12 months. Three patients complained of nasal regurgitation on thin fluids at 6 months. All 3 were asymptomatic at 12 months. Transit time was shortened overall. Functional Oral Intake Scale was higher. MD Anderson Dysphagia Inventory global (72.5% vs 45.7%, p = 0.003) and functional (62.0% vs 40.6%, p = 0.012) subscales were significantly improved at 24 months. Conclusion: Botox safely and effectively alleviates swallowing dysfunction associated with free jejunal flap for circumferential pharyngeal reconstruction. | - |
dc.language | eng | - |
dc.publisher | Pergamon. The Journal's web site is located at http://www.elsevier.com/locate/oraloncology | - |
dc.relation.ispartof | Oral Oncology | - |
dc.subject | Swallowing | - |
dc.subject | Swallowing disorder | - |
dc.subject | Swallowing dysfunction | - |
dc.subject | Free jejunal flap | - |
dc.subject | Circumferential pharyngectomy | - |
dc.title | Swallowing disorders following free jejunal flap reconstruction of circumferential pharyngeal defect: Does Botox help? | - |
dc.type | Article | - |
dc.identifier.email | Chow, VLY: chowlyv@hku.hk | - |
dc.identifier.email | Chan, JYW: jywchan1@hku.hk | - |
dc.identifier.authority | Chan, JYW=rp01314 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/j.oraloncology.2020.104612 | - |
dc.identifier.pmid | 32135435 | - |
dc.identifier.scopus | eid_2-s2.0-85080052298 | - |
dc.identifier.hkuros | 312140 | - |
dc.identifier.volume | 104 | - |
dc.identifier.spage | article no. 104612 | - |
dc.identifier.epage | article no. 104612 | - |
dc.identifier.isi | WOS:000529351800023 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 1368-8375 | - |