The Effect of Balloon Dilatation through Video-Fluoroscopic Swallowing Study (VFSS) in Stroke Patients with Cricopharyngeal Dysfunction

Objective To evaluate an effect of balloon catheter dilatation on post-swallow laryngeal elevation, total pharyngeal transit time and pharyngeal remnant in stroke patients with cricopharyngeal dysfunction. Method The 20 stroke patients with cricopharyngeal dysfunction in videofluoroscopic swallow study were recruited for the study. Using 16 Fr foley catheter, balloon was positioned across the upper esophageal sphincter under video-fluoroscopy. Balloon catheter dilatation was done for 3 minutes and each ballooning was repeated 6 times for a minute. We compared pre-balloon dilatation and post-balloon dilatation values. 3 factors were evaluated, which were laryngeal elevation, total pharyngeal transit time, and post-swallow pharyngeal remnant. Results There was no significant difference in laryngeal elevation after balloon dilatation. However, total pharyngeal transit time (p< 0.01) and pharyngeal remnant (p< 0.001) were significantly reduced after balloon dilatation. Conclusion There were significant decrements of post-swallow total pharyngeal transit time and pharyngeal remnant after balloon dilation procedure. Balloon dilation of upper esophageal sphincter can produce relief of dysphagia in stroke patients with cricopharyngeal dysfunction.