Quality of Life in Treating Persistent Neurogenic Dysphagia with Cricopharyngeal Myotomy.

ABSTRACT

Neurological impairment is an important cause of dysphagia. This study analyzed whether quality of life (QoL) is improved after coblation-assisted endoscopic cricopharyngeal myotomy (CAECPM) for patients with persistent neurological dysphagia who meet the criteria by using the Chinese version of the Swallow Quality-of-Life Questionnaire (CSWAL-QOL). 22 patients with dysphagia for more than 6 months after stroke or lateral skull base surgery were screened. All patients exhibited a poor response to conservative treatment such as swallowing rehabilitation. Videofluoroscopic swallowing studies (VFSS) showed a restricted cricopharyngeal opening. The preoperative CSWAL-QOL score was 377.7 (311.3-493.0) out of 1000; the postoperative score was 641.7 (293.7-758.3) out of 1000; the preoperative median dysphagia frequency was 41.4 (25.7-61.4) out of 100; and the postoperative median score was 64.3 (24.3-80.0). A significant difference was found between preoperative and postoperative scores together with dysphagia frequency (P < 0.05). Among all the variables, laryngeal elevation ability was statistically significantly correlated with efficacy of CAECPM (P = 0.01). These values indicate that quality of life could be improved after CAECPM for patients with persistent neurological dysphagia, who have cricopharyngeal achalasia. The ability of laryngeal elevation has significant influence. The CSWAL-QOL can be used to assess different aspects of the swallow-related quality of life of these patients.