Next Article in Journal
Aspergillus and Fusarium Mycotoxin Contamination in Maize (Zea mays L.): The Interplay of Nitrogen Fertilization and Hybrids Selection
Previous Article in Journal
7-Phenylheptanoic Acid-Hydroxypropyl β-Cyclodextrin Complex Slows the Progression of Renal Failure in Adenine-Induced Chronic Kidney Disease Mice
Previous Article in Special Issue
Long-Term Enhancement of Botulinum Toxin Injections for Post-Stroke Spasticity by Use of Stretching Exercises—A Randomized Controlled Trial
 
 
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Ultrasound-Guided Botulinum Neurotoxin Injection for Alleviating Cricopharyngeus Muscle Spasticity: A Cadaveric Feasibility Study with Nerve Ending Analysis

1
Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, 1332, Seongnam-daero, Seongnam 13120, Republic of Korea
2
Department of Anatomy, CHA University School of Medicine, 335, Pangyo-ro, Seongnam 13448, Republic of Korea
3
Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk University Ilsan Hospital, College of Medicine, 27 Dongguk-ro, Goyang 10326, Republic of Korea
*
Authors to whom correspondence should be addressed.
These authors equally contributed as corresponding authors.
Toxins 2024, 16(7), 317; https://doi.org/10.3390/toxins16070317
Submission received: 12 June 2024 / Revised: 7 July 2024 / Accepted: 9 July 2024 / Published: 12 July 2024
(This article belongs to the Special Issue The Botulinum Toxin and Spasticity: Exploring New Horizons)

Abstract

Botulinum neurotoxin (BNT) injection into the cricopharyngeus muscle (CPM) under ultrasound (US) guidance is a minimally invasive technique performed to relieve cricopharyngeal dysphagia by reducing CPM spasticity. This technique is basically accessible only to both lateral sides of the CPM. This cadaveric study aimed to evaluate whether US-guided injection could effectively deliver BNT to abundant areas of gross nerve endings within the CPM. We utilized a newly modified Sihler’s staining method to identify regions with abundant neural endings within the CPM while preserving the three-dimensional morphology of the muscle in 10 sides of 5 fresh cadavers. A mixture of 0.2 mL dye was injected into the 16 sides of CPM under US guidance in 8 cadavers. Nerve endings were abundant in posterolateral areas of the CPM; the injected dye was identified at the posterolateral area on 12 sides (12/16 side, 75%) without diffusion into the posterior cricoarytenoid muscle. The injection failed on four sides (two sides of the prevertebral fascia and two sides of the esophagus below the CPM). These results suggest that US-guided injection could be a feasible technique as it can deliver BNT to the most abundant nerve distribution areas within the CPM in most cases.
Keywords: botulinum toxins; deglutition disorders; muscle spasticity; ultrasonography; upper esophageal sphincter botulinum toxins; deglutition disorders; muscle spasticity; ultrasonography; upper esophageal sphincter

Share and Cite

MDPI and ACS Style

Lee, J.-H.; Lee, H.-J.; Kim, B.H. Ultrasound-Guided Botulinum Neurotoxin Injection for Alleviating Cricopharyngeus Muscle Spasticity: A Cadaveric Feasibility Study with Nerve Ending Analysis. Toxins 2024, 16, 317. https://doi.org/10.3390/toxins16070317

AMA Style

Lee J-H, Lee H-J, Kim BH. Ultrasound-Guided Botulinum Neurotoxin Injection for Alleviating Cricopharyngeus Muscle Spasticity: A Cadaveric Feasibility Study with Nerve Ending Analysis. Toxins. 2024; 16(7):317. https://doi.org/10.3390/toxins16070317

Chicago/Turabian Style

Lee, Ji-Hyun, Hyung-Jin Lee, and Bo Hae Kim. 2024. "Ultrasound-Guided Botulinum Neurotoxin Injection for Alleviating Cricopharyngeus Muscle Spasticity: A Cadaveric Feasibility Study with Nerve Ending Analysis" Toxins 16, no. 7: 317. https://doi.org/10.3390/toxins16070317

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop