Evidence map›Paper›PMID 42152494›Full record

ArticleThe Laryngoscope2026

Management of Absent Upper Esophageal Sphincter Opening After Neurological Injury.

Radhika Rawat, Cyrus W Abrahamson, Kelly Rogers, Jonelyn Langenstein, Jaymie Bromfield, Arjun Seth, James A Burns, Andrew P Stein

Abstract read
In one paragraph

Article in The Laryngoscope, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Radhika RawatNorthwestern University Feinberg School of Medicine, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0002-6101-2625
Cyrus W AbrahamsonNorthwestern University Feinberg School of Medicine, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0002-6359-5393
Kelly RogersThink + Speak Lab, Shirley Ryan AbilityLab, Chicago, Illinois, USA.
Jonelyn LangensteinDepartment of Otolaryngology - Head and Neck Surgery, Northwestern Medicine, Chicago, Illinois, USA.
Jaymie BromfieldDepartment of Otolaryngology - Head and Neck Surgery, Northwestern Medicine, Chicago, Illinois, USA.
Arjun SethDepartment of Neurology, Northwestern Medicine, Chicago, Illinois, USA.
James A BurnsDepartment of Otolaryngology - Head and Neck Surgery, Northwestern Medicine, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0002-0772-4429
Andrew P SteinDepartment of Otolaryngology - Head and Neck Surgery, Northwestern Medicine, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0002-2551-1064

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the effects of swallowing therapy and cricopharyngeus (CP) muscle surgery on upper esophageal sphincter (UES) opening, oral intake, and airway protection in patients with absent UES opening following neurological injury.

methodsRetrospective review of seven patients managed between September 2021 and July 2024 with absent UES opening confirmed by Modified Barium Swallow Study (MBSS). All patients underwent swallowing therapy followed by at least one CP-targeted intervention, including balloon dilation, botulinum toxin injection, and/or myotomy. Swallowing outcomes were assessed using the Functional Oral Intake Scale (FOIS), Mann Assessment of Swallowing Ability (MASA), Penetration-Aspiration Scale (PAS), and pharyngoesophageal segment (PES) opening scores from the Modified Barium Swallow Impairment Profile.

resultsCP-targeted surgeries were associated with improved FOIS, MASA, and PES opening scores. PAS scores did not change substantially, with six patients demonstrating values greater than or equal to 7. Patients who underwent CP-directed intervention within 6 months of injury demonstrated greater FOIS improvements than those treated later (3.25 vs. 0.33).

conclusionCP interventions can facilitate improved bolus passage and oral intake in patients with absent UES opening following neurological injury. However, persistent aspiration risk remains despite improved mechanical opening, highlighting the need for continued swallowing therapy. Finally, earlier intervention may optimize outcomes, though further research is needed to refine treatment for this rare condition. LEVEL OF EVIDENCE: 4:

Indexed as

Deglutition DisordersEsophageal Sphincter, UpperAdultDeglutitionFemaleHumansMaleMiddle AgedMyotomyPharyngeal MusclesRetrospective Studiescricopharyngeal muscle dysfunctioncricopharyngeal surgerydysphagiaswallowing therapyupper esophageal sphincter

Identifiers

PMID42152494
PMCPMC13569688

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.