Pitfalls of Surgical Treatment for Dysphagia

Abstract

Surgical treatments for restoring swallowing function, such as cricopharyngeal myotomy or laryngeal elevation are effective interventions for severe dysphagia. There are, however, some pitfalls including therapeutic differentiation between surgeries and rehabilitation, causes of insufficient postoperative results, and long-term outcomes. We herein discussed these issues via our cases that underwent surgical management.
　By retrospective analysis of cases with Wallenberg's syndrome, rehabilitation could successfully restore swallowing function in cases with fair pharyngolaryngeal sensory function and swallowing reflex. These are important factors for considering the course of treatment. None of the four cases with predominant pseudo-bulbar palsy due to cerebrovascular disorders had sufficient oral food intake restored. The highly disordered activities of daily living were thought to be additional contributing factors of poor postoperative results. Skilled surgical procedure is a clear necessity. In the long-term, local scarring or systemic functional deterioration may lead to reworsening of swallowing function. Clinicians should be aware of these issues in treating dysphagic patients surgically.