Efficacy observation of electromyography-guided targeted injection of swallowing muscles for treating dysphagia resulting from medullary paralysis.

OBJECTIVE

To observe the clinical efficacy of electromyography (EMG)-guided targeted mecobalamin injections for treating dysphagia resulting from medullary paralysis and to investigate effective dysphagia management strategies.

METHODS

This study was a prospective randomized controlled trial. A total of 110 patients with dysphagia due to post-stroke bulbar palsy were enrolled at Baoding No.1 Central Hospital from February 2017 to December 2020. Patients were randomly assigned using a random number table to either a control group (n = 55) receiving conventional pharmacotherapy combined with rehabilitation training, or a treatment group (n = 55) receiving the same conventional therapy plus additional EMG-guided targeted injections of mecobalamin into the swallowing muscles. Swallowing function was assessed using the Wada water swallowing test (WST) and videofluoroscopic swallowing study (VFSS) after 2 weeks of treatment.

RESULTS

The treatment group showed a significantly higher overall response rate on the WST than the control group (P < 0.05). Based on VFSS, the marked and overall effectiveness rates were 50.9% and 96.4% in the treatment group, respectively, significantly higher than the corresponding rates of 18.2% and 83.6% in the control group (both P < 0.05). The incidence of aspiration decreased significantly in both groups post-treatment (P < 0.05), with a more pronounced reduction observed in the treatment group (P < 0.05).

CONCLUSION

EMG-guided targeted injection of mecobalamin into swallowing muscles is an effective adjunctive strategy for enhancing swallowing function in patients with dysphagia due to post-stroke medullary paralysis.