散发性包涵体肌炎(s-IBM)是一种获得性退行性炎症性肌病,可导致四肢缓慢进行性肌肉无力和萎缩,脸,和咽部。由于疾病进展缓慢,手术干预的指征仍不清楚.在这里,我们回顾性回顾了4例s-IBM患者的记录,这些患者在2016年至2021年期间在我们机构接受了严重吞咽困难的环咽肌切开术.其中,一名患者接受了经颈喉肌切开术和喉悬吊术,由于吞咽的视频透视检查显示喉部抬高不良。其余三名患者使用弯曲的刚性喉镜进行了内窥镜环咽肌切开术。术前,使用软式内窥镜,Hyodo评分平均为8分(范围:6~10分).平均手术时间为104分钟,无严重并发症发生。术后,所有患者的吞咽功能和食物摄入均得到改善.此外,所有4例患者术后6-12个月仍维持吞咽功能。环咽肌切开术可能是一种安全的外科手术,有可能改善吞咽功能,Hyodo评分为6分可能被认为是s-IBM患者环咽肌切开术的手术指征。
Sporadic inclusion body myositis (s-IBM) is an acquired degenerative inflammatory myopathy that leads to slowly progressive muscle weakness and atrophy of the limbs, face, and pharynx. Owing to the slow progression of the disease, the indications for surgical intervention remain unclear. Herein, we retrospectively reviewed the records of four patients with s-IBM who had undergone cricopharyngeal
myotomy for severe dysphagia at our institution between 2016 and 2021. Among these, one patient underwent transcervical cricopharyngeal
myotomy and laryngeal suspension, as videofluoroscopic examination of swallowing revealed poor laryngeal elevation. The remaining three patients underwent endoscopic cricopharyngeal
myotomy using a curved rigid laryngoscope. Preoperatively, the mean Hyodo score was 8 points (range: 6-10) using a flexible endoscope. The mean surgical duration was 104 min, and no severe complications were observed. Postoperatively, all patients achieved improvement in swallowing function and food intake. Moreover, swallowing function was maintained in all four patients even 6-12 months postoperatively. Cricopharyngeal
myotomy may be a safe surgical procedure with the potential to improve swallowing function, and a Hyodo score of 6 may be considered a surgical indication for cricopharyngeal
myotomy in patients with s-IBM.