Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Efficacy of Ultrasound Guided Botulinum Toxin Injection for Cricopharyngeal Dysphagia in Post-Stroke Patients: A Randomized Controlled Pilot Study
Debarghya Chattopadhyay, Rajesh Pramanik, Biman Kanti Roy and Debayan Ghorai
Page: 156-161 | Received 05 Sep 2023, Published online: 25 Oct 2023
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Abstract
Dysphagia means difficulty in swallowing is a common symptom following stroke. Most of these patients usually recover within two months of their cerebrovascular accident. But some of them suffer from dysphagia for a longer period which can lead to malnutrition, dehydration and in more severe case aspiration pneumonia. Rehabilitative swallowing therapy (RST), Neuromuscular Electrical Stimulation over anterior neck musculature, Endoscopic Pharyngeal stimulation, Transcranial magnetic stimulation, EMG biofeedback, Botulinum toxin (BTX) injection in cricopharyngeus muscle etc were the mainstay of treatment. We have tried to assess any improvement in video fluoroscopic dysphagia scale(VDS) after Botulinum toxin injection along with swallowing techniques, maneuvers and videofluroscopic improvement of swallowing in post stroke dysphagia patients in both-botulinum toxin injection and conservative management group and compared the improvement of swallowing between them. The present study was randomized controlled pilot study. This study was conducted from 18 months at Department of Physical Medicine and Rehabilitation, IPGME and R, SSKM Hospital, Kolkata. Total 16 patients were included in this study. Mean Baseline VDS score was 82.5±3.12 in Group A and 83.0±4.07 in Group B. There is no statistically significant difference in Mean Baseline VDS score as p-value is >0.05. Mean VDS score after 1 month of intervention was 78.5±7.23 in Group A and 79.75±6.54 in Group B. There is no statistically significant difference in Mean VDS score after 1 month of intervention as p-value is >0.05. Mean VDS score after 3 months of intervention was 70.75±7.85 Group A and 49.75±6.63 in Group B. There is statistically significant difference in Mean VDS score after 3 months of intervention as p-value <0.0001. Mean VDS score was more or less same in both Group A and Group B in Baseline data and after 1 month Data. But after 3 months of Intervention mean VDS score showed sharp decline in graphs. This reveals that intervention group had similar outcome after one month (p-value>0.05) but statistically significant better out come after 3 months of intervention (p<0.0001).The majority of PSD patients have ischemia comorbidities. After one month and three months of follow-up both the conservative management (RST) group (A) and the RST with Botulinum toxin (BTX) injection group (B) have clearly improved. Improvement was comparable across the two groups after a month of follow-up. But after that group A’s progress was not sufficient compared to group B’s considerable recovery between one month and three months following the injection of botulinum toxin.
How to cite this article:
Debarghya Chattopadhyay, Rajesh Pramanik, Biman Kanti Roy and Debayan Ghorai. Efficacy of Ultrasound Guided Botulinum Toxin Injection for Cricopharyngeal Dysphagia in Post-Stroke Patients: A Randomized Controlled Pilot Study.
DOI: https://doi.org/10.36478/10.59218/makrjms.2023.12.156.161
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2023.12.156.161