Treatment of Cricopharyngeal Dysphagia with Shaker's Head Lift Exercise / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Cricopharyngeal dysphagia refers to the dysfunction of the upper esophageal sphincter complex, which is composed of the cricopharyngeus, inferior pharyngeal constrictor and the upper segment of the cervical esophagus. Adequate relaxation of the cricopharyngeal muscle in conjunction with anterosuperior excursion of the larynx by suprahyoid muscles and propulsion of food bolus are prerequisite for normal swallow, mechanisms of which, if altered, may result in cricopharyngeal dysfunction. Head lift exercise, first described by Shaker, can be utilized in patients with cricopharyngeal dysphagia by strengthening the suprahyoid musculature and reducing the intrabolus pressure. The objective of this study was to introduce Shaker's head lift exercise in the treatment of cricopharyngeal dysphagia patients. SUBJECTS AND METHOD: Two patients suffering from cricopharyneal dysphagia after receiving skull base surgery were managed with Shaker's head lift exercise and the swallowing function was evaluated with videofluoroscopy. RESULTS: Both patients who had been taught how to perform head lift exercise showed improvement in swallowing function as observed with videofluoroscopy. Aspiration disappeared and both patients were able to take oral diet without the aid of gastrostomy tubes. CONCLUSION: Shaker's head lift exercise enabled oral feeding without aspiration in two patients. This demonstrates that Shaker's head lift exercise can be a promising noninvasive treatment modality in the treatment of cricopharyngeal dysphagia.