{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:07:40Z","timestamp":1789186060153,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective 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\u2010targeted 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\u2010Aspiration Scale (PAS), and pharyngoesophageal segment (PES) opening scores from the Modified Barium Swallow Impairment Profile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CP\u2010targeted 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\u2010directed intervention within 6\u2009months of injury demonstrated greater FOIS improvements than those treated later (3.25 vs. 0.33).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CP 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>4<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70630","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:24:37Z","timestamp":1779168277000},"page":"4383-4391","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of Absent Upper Esophageal Sphincter Opening After Neurological Injury"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6101-2625","authenticated-orcid":false,"given":"Radhika","family":"Rawat","sequence":"first","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6359-5393","authenticated-orcid":false,"given":"Cyrus W.","family":"Abrahamson","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Rogers","sequence":"additional","affiliation":[{"name":"Think + Speak Lab, Shirley Ryan AbilityLab  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonelyn","family":"Langenstein","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Northwestern Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaymie","family":"Bromfield","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Northwestern Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Seth","sequence":"additional","affiliation":[{"name":"Department of Neurology Northwestern Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0772-4429","authenticated-orcid":false,"given":"James A.","family":"Burns","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Northwestern Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2551-1064","authenticated-orcid":false,"given":"Andrew P.","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Northwestern Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011350"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13113879"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP285564"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0002\u20109343(99)00337\u2010x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.2001.81.2.929"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ddrr.12"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010024\u201008644\u20107"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12213"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2017.00080"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022\u20105223(97)70318\u20100"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurot.2024.e00433"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.5535\/arm.2018.42.2.204"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.11.049"},{"key":"e_1_2_9_15_1","volume-title":"MASA, the Mann Assessment of Swallowing Ability","author":"Mann G.","year":"2002"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.30.4.744"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00417897"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010008\u20109185\u20109"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010007\u20109097\u20100"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010021\u201010349\u20106"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016\u20105085(89)90391\u20100"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537\u2010200003000\u201000021"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1113\/jp272368"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1044\/2021_jslhr\u201021\u201000238"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70630","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70630","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70630","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:20:49Z","timestamp":1789183249000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70630"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,18]]},"references-count":23,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/lary.70630"],"URL":"https:\/\/doi.org\/10.1002\/lary.70630","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,18]]},"assertion":[{"value":"2026-02-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}