Combined cricopharyngeal myotomy and autologous fat injection laryngoplasty: an effective surgery for dysphagia following glossopharyngeal and vagal nerve injury
10.3760/cma.j.cn115330-20250408-00217
- VernacularTitle:同期环咽肌切除术联合声带自体脂肪注射术治疗舌咽迷走神经损伤后吞咽困难的疗效分析
- Author:
Yanyan NIU
1
;
Wei GU
1
;
Xiaofeng JIN
1
;
Tingting CUI
1
;
Hong HUO
1
;
Jian WANG
1
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院耳鼻咽喉科，北京 100730
- Publication Type:Journal Article
- Keywords:
Dysphagia;
Cricopharyngeal myotomy;
Autologous fat injection laryngoplasty;
Vagal nerve injury;
Glossopharyngeal nerve injury
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2025;60(11):1357-1362
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of combined cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) in the management of dysphagia secondary to glossopharyngeal and vagal nerve injury.Methods:This retrospective cohort study collected the clinical data of 18 patients with persistent dysphagia due to glossopharyngeal and vagus nerve injuries, who underwent concurrent cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) at the Department of Otolaryngology, Peking Union Medical College Hospital, from January 2017 to December 2024. Pre-and postoperative assessments included electronic flexible laryngoscope, the Chinese version of Swallow Quality-of-Life Questionnaire (CSWAL-QOL), videofluoroscopic swallowing study (VFSS), body weight changes, and nasogastric tube (NGT) removal status with routine follow-up. The comparison of swallowing function before and after surgery was conducted using paired samples t-test and χ2 test. Results:The study cohort comprised 10 male and 8 female patients, with ages ranging from 33 to 70 years (mean±SD: 53.8±10.5). All surgical procedures were completed successfully without complications. During the 6-to 24-month follow-up period, 10 of the 13 patients who were initially nasogastric tube-dependent achieved successful decannulation. Compared with preoperative values, postoperative measurements demonstrated statistically significant improvements across all parameters: mean body weight increased from (56.95±9.14) kg to (59.22±8.72) kg ( t=3.689 , P<0.01), CSWAL-QOL scores improved from 91.89±17.81 to 130.83±25.42 ( t=6.921 , P<0.01), while, both VFSS scales showed marked reductions (VFSS-SWAL: 6.78±1.40 to 3.39±1.61, t=-8.001, P<0.01; PAS: 6.56±1.15 to 2.94±1.26, t=-10.114, P<0.01). Conclusions:Combined CPM and AFIL represents an effective surgical approach for dysphagia following glossopharyngeal and vagal nerve injury, thereby demonstrating significant improvements in both swallowing function and quality of life.
