Effect of different doses of Botulinum toxin type A injected under ultrasound guidance combined with modified catheter-balloon localization for post-stroke cricopharyngeal dysfunction: a randomized controlled trial
10.3969/j.issn.1006-9771.2026.07.005
- VernacularTitle:超声引导联合改良导管球囊定位下不同剂量A型肉毒毒素治疗脑卒中后环咽肌功能障碍的效果
- Author:
Liubo FAN
1
;
Tingting SHAN
1
;
Baohua LIU
2
;
Mimi LUO
1
;
Luding ZHANG
1
;
Minghui WANG
1
Author Information
1. Department of Rehabilitation Medicine, Affiliated Taizhou Hospital of Wenzhou Medical University, Taizhou, Zhejiang 317000, China
2. Department of Rehabilitation Medicine, Affiliated First Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325035, China
- Publication Type:Journal Article
- Keywords:
stroke;
dysphagia;
cricopharyngeal dysfunction;
Botulinum toxin type A;
ultrasound guidance;
dose-efficacy relationship
- From:
Chinese Journal of Rehabilitation Theory and Practice
2026;32(7):776-787
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the short-term efficacy and safety of different doses of Botulinum toxin type A (BTX-A) injected under ultrasound guidance combined with modified catheter-balloon localization for post-stroke cricopharyngeal dysfunction (CPD), and to explore a relatively appropriate dose. MethodsA total of 136 patients with post-stroke CPD admitted to Taizhou Hospital of Zhejiang Province from December, 2023 to February, 2026 were randomly assigned into control group, 50 U group, 70 U group and 100 U group, with 34 patients in each group. The control group received conventional rehabilitation, whereas the three BTX-A groups received conventional rehabilitation plus the corresponding dose of BTX-A injected under ultrasound guidance combined with modified catheter-balloon localization. Videofluoroscopic Swallowing Study (VFSS) scores, Functional Oral Intake Scale (FOIS) scores, Yale Pharyngeal Residue Severity Rating Scale (YPR-SRS) grades, Murray Secretion Severity Scale (MSS) grades and ultrasonographic parameters were compared before and two weeks after intervention. ResultsAfter intervention, FOIS scores improved significantly in all groups (|Z| > 2.843, P < 0.01), and YPR-SRS and MSS grades also showed significant improvements in all BTX-A groups (|Z| > 4.147, P < 0.001). Pairwise comparisons revealed that the order of improvement from best to worst for FOIS, YPR-SRS and MSS grades was the 100 U group, followed by 70 U group, and then 50 U group (P < 0.05). For VFSS scores, the effect of time, group and interaction were all significant (F > 9.68, P < 0.001); pairwise comparisons showed that 100 U group achieved the best outcomes (P < 0.001). Regarding the activity and velocity of the geniohyoid muscle, the effects of time, group and interaction were also significant (F > 7.34, P < 0.001); pairwise comparisons indicated that 100 U group outperformed the other groups in both activity and velocity (P < 0.001). For hyoid bone displacement distance and shortening rate, the effects of time and interaction were significant (F > 3.07, P < 0.05), and the main effects of time on duration and velocity were significant (P < 0.01); pairwise comparisons showed that the 100 U group had superior displacement distance and shortening rate compared to the other groups (P < 0.05). During the treatment and follow-up periods, no serious adverse event occurred in any group. ConclusionUltrasound-guided BTX-A injection assisted by modified catheter-balloon localization may further improve short-term swallowing function in patients with post-stroke CPD， with a dosage of 100 U.
