超声引导下肉毒毒素环咽肌注射治疗延髓背外侧综合征所致吞咽障碍1例报道

doi:10.3969/j.issn.1006-9771.2020.11.020

Abstract

Abstract:

Objective To investigate the effect of cricopharyngeal injection of Botulinum toxin under ultrasonic guidance for treatment of dysphagia caused by Wallenberg’s syndrome.Methods A case was reviewed.Results This patient was diagnosed as cricopharyngeal achalasia after dorsal lateral rostral infarction, and responded poor to routine treatment for swallowing disorders, including balloon dilatation. He accepted cricopharyngeal Botulinum toxin injection under ultrasonic guidance. As evaluated with Toshima Ichiro Ingestion-Swallowing Function Rating Scale, Rosenbek Penetration-Aspiration Scale and videofluoroscopic swallowing study (VFSS), his swallowing improved after treatment, and became normal as follow-up one and three months after treatment.Conclusion Cricopharyngeal Botulinum toxin injection under ultrasonic guidance is feasible for cricopharyngeal achalasia of Wallenberg’s syndrome with immediate and long-term effect.

Key words: Wallenberg’s syndrome, dysphagia, cricopharyngeal achalasia, Botulinum toxin, ultrasonic guidance

CLC Number:

R743.3

YANG Ying,XU Mei-na,LI Xiang-liang,XIE Luan,JIN Hai-peng. Cricopharyngeal Botulinum Toxin Injection under Ultrasonic Guidance for Dysphagia from Wallenberg’s Syndrome: A Case Report[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(11): 1358-1364.

Figures/Tables 20

References 30

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时间	藤岛一郎摄食-吞咽功能	渗漏-误吸量表
常规治疗前	2	8
常规治疗1周后	3	8
A型肉毒毒素治疗后第2天	9	1
出院后1个月	10	1
出院后3个月	10	1

时间	藤岛一郎摄食-吞咽功能	渗漏-误吸量表
常规治疗前	2	8
常规治疗1周后	3	8
A型肉毒毒素治疗后第2天	9	1
出院后1个月	10	1
出院后3个月	10	1

时间	舌骨上移 (mm)	舌骨前移 (mm)	甲状软骨上移 (mm)	甲状软骨前移 (mm)	UES开放时间 (s)	UES开放幅度 (cm)	咽腔收缩率 (%)
常规治疗前	11	2	14	3	0.3	0.6	71.5
常规治疗1周后	12	3	17	3	0.4	0.7	73.4
A型肉毒毒素治疗后第2天	13	10	19	4	0.8	0.8	92.6
出院后1个月	18	12	21	5	0.9	1.0	94.9
出院后3个月	20	13	21	6	1.1	1.1	98.0

时间	舌骨上移 (mm)	舌骨前移 (mm)	甲状软骨上移 (mm)	甲状软骨前移 (mm)	UES开放时间 (s)	UES开放幅度 (cm)	咽腔收缩率 (%)
常规治疗前	11	2	14	3	0.3	0.6	71.5
常规治疗1周后	12	3	17	3	0.4	0.7	73.4
A型肉毒毒素治疗后第2天	13	10	19	4	0.8	0.8	92.6
出院后1个月	18	12	21	5	0.9	1.0	94.9
出院后3个月	20	13	21	6	1.1	1.1	98.0

Cricopharyngeal Botulinum Toxin Injection under Ultrasonic Guidance for Dysphagia from Wallenberg’s Syndrome: A Case Report

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[2]	GAO Fei, LIU Lixu, YUAN Yongxue. Clinical characteristics and rehabilitation of dysphagia after brainstem stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(4): 465-471.
[3]	ZHOU Hui, GONG Zunke, TIAN Gengrun, GU Chengchen, WANG Shiyan, WANG Mi. Application of fiberoptic endoscopic examination of swallowing combined with dye test in silent aspiration after stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(2): 231-237.
[4]	HUANG Zhilin, XU Fashao, SHI Jing, HUANG Gan, LIU Meifang, ZHANG Xiahui. Establishment of rat model of dysphagia after stroke by thread embolism [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(10): 1147-1153.
[5]	LI Yingcai,LENG Jun,MENG Xiangzhi,CHEN Yiting,ZHANG Siyu,WEI Yanxu,REN Hui. Advance in post-stroke dysphagia in the last five years: a visualization analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(9): 1049-1059.
[6]	CHENG Wei,XUE Lingli,DONG Linsheng,LI Yadong. Factors related to dysphagia early after surgery for head-and-neck squamous cell carcinoma [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(9): 1074-1078.
[7]	CHEN Jinjin,AERKEN Rufeina,WU Silin,MENG Dianhuai,ZHOU Yuntao. Advance in chin-down maneuver in aspiration for dysphagic patients (review) [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(7): 816-821.
[8]	ZHOU Xuezhen,WU Wenxiu,LIN Zuchen,LI Haiyan,YE Suzhen. Effect of Kinesio taping on salivation for stroke patients with dysphagia [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(5): 530-533.
[9]	WANG Bo,YUAN Yongxue,ZHANG Qingsu. Factors related to swallowing recovery for nil per os patients after stroke and prediction model [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(4): 453-460.
[10]	ZHANG Pingping,ZHANG Ting,FENG Haiyang,LI Zhenrong,CHEN Ping,LI Tao,LU Dezhi,WANG Xiaowen. Investigation on dysphagia and aspiration among the elderly in nursing home in Weifang, Shandong, China [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(4): 467-472.
[11]	WANG Xiaoxue,YANG Chen,SUN Fei,DU Qianhua,ZHANG Jun. Effect of family-based swallowing training program on swallowing function for patients with head and neck cancer undergoing radiotherapy [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(2): 227-231.
[12]	CHEN Jia-jun,WU Deng-chong,SHAO Xiang-zhi,PU Xin-yu,MAO Yan-wu,CHEN Bing. Effects of Transcranial Direct Current Stimulation over Vagus Nerve on Dysphagia after Stroke [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(9): 1078-1081.
[13]	YUAN Yong-xue,ZHANG Qing-su. Factors Related to Rehabilitation Outcome of Dysphagia for Patients with Cricopharyngeal Dysfunction [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(8): 973-977.
[14]	Zhi-cheng LIN,Yong-mei YOU,Jun WANG,Wei WEI,Min XIA,Xie-hua XUE. Functional Connectivity from Hypothalamus and Whole Brain Anisotropy in Patients with Dysphagia after Stroke: A Study with Magnetic Resonance Imaging [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(5): 504-509.
[15]	ZHANG Yong-mei,XI Shu-xin. Advance in Mechanism and Rehabilitation of Dysphagia after Laryngectomy (review) [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(8): 908-912.