Effect of cricopharyngeus muscle surgery on the pharynx

Jacqui Allen, Cheryl J. White, Rebecca J Leonard, Peter C Belafsky

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Objectives/Hypothesis: Cricopharyngeus muscle dysfunction (CPD) ranges from asymptomatic cricopharyngeal bar (CPB) to Zenker's diverticulum. Previous work suggests that CPD can result in dilation and weakening of the pharynx above the obstruction. The purpose of this investigation was to evaluate the ability of surgery on the cricopharyngeus muscle to improve pharyngeal area and strength. Study Design: Retrospective case study. Methods: Videofluoroscopic swallowing studies of all persons with CPD who underwent cricopharyngeus (CP) intervention followed by routine postoperative fluoroscopic study, between October 1, 1999 and January 1, 2010 were reviewed. Objective measures of pharyngeal area and constriction were obtained from pretreatment and post-treatment studies. Paired t tests and repeated measures analysis of variance were employed to compare results. Results: Fifty-four patients were included. Pharyngeal constriction and pharyngoesophageal segment (PES) opening improved significantly after intervention (P < .05). Pharyngeal dilation was unchanged (P > .05). PES opening improved more with CP myotomy than with dilation and botulinum toxin. Conclusions: Relief of CP obstruction by surgery or dilation improves pharyngeal constriction and PES opening. Dilation of the pharynx possibly related to prolonged outlet obstruction does not improve. CP myotomy appears more effective than dilation or botulinum toxin in relieving obstruction.

Original languageEnglish (US)
Pages (from-to)1498-1503
Number of pages6
JournalLaryngoscope
Volume120
Issue number8
DOIs
StatePublished - Aug 2010

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Keywords

  • Botulinum toxin
  • Cricopharyngeal achalasia
  • Cricopharyngeal bar
  • Cricopharyngeal dysfunction
  • Cricopharyngeal obstruction
  • Cricopharyngeus muscle
  • Dilation
  • Myotomy
  • Oropharyngeal dysphagia
  • Pharyngeal constriction
  • Pharyngeal constriction ratio
  • Pharyngeal dysphagia
  • Upper esophageal sphincter
  • Videofluoroscopic swallowing study

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Medicine(all)

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