The first experience in Russia of treating neurogenic cricopharyngeal dysphagia using intrasphincteric injection of botulinum toxin type A

Dysphagia is a common symptom of many diseases. Thus, the incidence of dysphagia in Parkinson’s disease is 11–81%, in patients with traumatic brain injury accounts of27–30%, in community-acquired pneumonia it reaches 91.7%, in Alzheimer’s disease — up to 85.9%, in mental illnesses — 9–42%. According to observational studies, dysphagia is diagnosed in 8.1–90.0% of patients with acute cerebrovascular accident. We found no report on the use of botulinum toxin in the Russian Federation for the treatment of dysphagia due to spasm of the upper esophageal sphincter (UES).

The aim of the work is to describe the first botulinum toxin type A injection experience for spasm of the UES in Russia.

The first experience in treating neurogenic cricopharyngeal dysphagia using intrasphincteric injection of botulinum toxin type A Russia is described.

We injected 100 units of botulinum toxin diluted in 4 ml of 0.9% sodium chloride solution symmetrically into 4 points (25 units, 1 ml at each point) in the spasm zone of the UES. In our case, the first effect from the injection of botulinum toxin appeared after 24 hours, and the maximum effect was recorded after 6 days. In our case, we observe no side effect after the injection of botulinum toxin. The effect of the procedure persists for 30 days after the injection of botulinum toxin type A into the UES under the control of endoscopic ultrasonography.

Conclusion. Dysphagia is a common complication of many neurological diseases, including acute cerebrovascular accident. Aspiration and pneumonia due to swallowing disorder lead to an increase in the duration of hospital treatment, worsen the prognosis of the disease, and the patient’s quality of life. The injection of botulinum toxin type A for the treatment of neurogenic dysphagia due to spasm of the UES under the control of endoscopic ultrasonography is an effective, safe and minimally invasive treatment method, due to which it can be used in the acute period of acute cerebrovascular accident.

Contribution:
Ramazanov G.R. — article concept and design, writing text, editing;
Yartsev P.A. — concept and design of the article;
Kovaleva E.A. — article concept and design, writing text, editing;
Shevchenko E.V. — editing;
Teterin Yu.S. — concept and design of the article;
Makarov A.V. — writing text, editing;
Korigova H.V. — writing text;
Akhmatkhanova L.H-B. — writing text;
Petrikov S.S. — editing.
All co-authors — approval of the final version of the article, responsible for the integrity of all parts of the article.

Acknowledgements. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: June 18, 2024
Accepted: July 24, 2024
Published: October 30, 2024

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