TITLE:
Botulinum Toxin A in the Treatment of Oropharyngeal or Esophageal Dysphagia
AUTHORS:
Caroline Beutner, Katharina Bartsch, Harald Schwörer, Rainer Laskawi, Saskia Rohrbach
KEYWORDS:
Botulinum Toxin; Dysphagia; Upper Esophageal Sphincter; Lower Esophageal Sphincter
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.2 No.6,
November
8,
2013
ABSTRACT: Objectives: In this retrospective analysis, we explored
the effect of botulinum toxin A (BTA) injection to treat oropharyngeal dysphagia or esophageal
dysfunction caused by diseases of the upper (UES) and lower (LES) esophageal
sphincter. Methods: In total, 48 patients (17 patients with UES
disorders, and 31 patients with LES dysfunction; mean age 64 years) were
treated between 1996 and 2007 in our hospital. Comorbid diseases as well as
maintenance medication were documented to evaluate the overall health status of our
patients. The mean duration of symptoms, the number of pre-treatments and the specification
of dysphagia were considered. Results: One month after injection, the response
rates were 73.3% (UES group) and 76.6% (LES group). Most patients in the UES
group received 30-40 units BTA (Botox?) whereas most patients in the LES group
were treated with 100 units BTA. In cases of re-injection, 50% of patients in
the UES group experienced an escalation of dosage (up to 75 units), whereas
the other 50% received the same dosage. The dosages in the LES group were
mostly kept constant. Conclusion: Comparing the two groups with
esophageal dysfunction of fundamentally different etiologies (UES/LES), a
discrepancy in the level of symptom relief, onset and a longer cessation of
clinical benefit were observed in the LES group. In this analysis, we were able
to show that injection of BTA is an effective and safe treatment for disorders
of the UES and LES.