The use of botulinum toxin in the treatment of upper esophageal sphincter spasm: a diagnostic protocol and case series.

<ns3:p>Introduction: Botulinum toxin is used to treat spasms, including those of the upper esophageal sphincter. Dilating the UES with a balloon or performing myotomy of the cricopharyngeal muscle constitute alternatives to this method.Aim of the study: To present the principles of the qualification for the procedure, speech therapy prehabilitation and subsequent rehabilitation, as well as methods for monitoring the effects of therapy and its effectiveness.Diagnostic and therapeutic protocol: It should comprise clinical functional assessment (the role of a phoniatrist), gastroenterological consultation, functional tests (FEES, VFSS, HRM), and patient preparation for the procedure, rehabilitation after the procedure and monitoring the effects of the therapy (the role of the phoniatrist and speech therapist). Diagnostic and therapeutic challenges were discussed in three clinical cases: two patients after surgery for skull base tumors and one patient after meningitis.Conclusions: Planning botulinum toxin injection into the UES requires an interdisciplinary diagnostic and therapeutic approach to increase the chance of success of the procedure.</ns3:p>