Swallowing Improvement Surgery for Dysphagia in Wallenberg Syndrome: A Scoping Review of the English and Japanese Literature

Abstract

Background: Dysphagia associated with Wallenberg syndrome (WS) often improves with swallowing rehabilitation; however, persistent cases may require surgical intervention. Various swallowing improvement procedures have been reported, but their strategies and outcomes remain unclear. This scoping review summarized the evidence on swallowing improvement surgery for WS. Methods: PubMed, Scopus, Web of Science, and Ichushi-Web were searched in accordance with the PRISMA-ScR framework. English- and Japanese-language studies reporting swallowing improvement surgery for WS were included. Patient characteristics, surgical procedures, outcomes, and complications were descriptively synthesized. Results: Twenty-one studies involving 53 patients met the inclusion criteria. Most patients had profound preoperative dysphagia requiring enteral feeding. Cricopharyngeal myotomy was performed in all patients, and at least 66.0% underwent combined procedures, most commonly with laryngeal suspension. Available postoperative data indicated improved oral intake in many patients, although outcome reporting was incomplete. Some patients required staged procedures because a single procedure did not adequately address their complex swallowing impairment. Conclusions: Reported outcomes suggest that swallowing improvement surgery may contribute to improved oral intake in selected patients with WS. The frequent use of combined procedures highlights the importance of individualized, pathophysiology-based surgical management. However, the evidence cannot distinguish surgical effects from spontaneous recovery, rehabilitation, or patient selection.