The Prevalence of Cricopharyngeal Webs in Elderly Cadavers

Omid B. Mehdizadeh, Peter Wickwire, Mena Said, Peter C Belafsky

Research output: Contribution to journalArticle

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Abstract

Objective: Cricopharyngeal webs (CPW) are a frequent cause of solid food dysphagia. They are difficult to diagnose and are often missed on swallowing fluoroscopy. The prevalence of CPWs is uncertain. The purpose of this study was to determine the prevalence of CPWs in elderly cadavers. Methods: Direct laryngoscopy and cervical esophagoscopy were performed in 19 embalmed cadavers by independent two-clinician consensus. Cadaver demographics and the presence and laterality of a CPW were recorded. The prevalence of CPW was calculated, and the size of the cricopharyngeus muscle (CPM) was quantified. Results: The mean age of the cohort was 83 (± 12) years. Fifty-three percent were female, and the mean body mass index was 19.7 (± 3). The causes of death were cardiovascular disease (10 of 19), cancer (5 of 19), and respiratory failure (4 of 19). A CPW was present in 68% (13 of 19) of cadavers. Forty-seven percent (9 of 19) had a unilateral web, and 21% (4 of 19) had a bilateral web. There was no laterality predominance (P > 0.05). Forty-two percent (8 of 19) had no CPM prominence; 32% (6 of 19) had a small/moderate CPM prominence; and 26% (5 of 19) had a significant CPM prominence. Conclusion: The prevalence of cricopharyngeal webs in elderly cadavers is high (68%). The clinician should maintain a high index of suspicion for CPWs in patients with no other identifiable etiology of solid food dysphagia. Level of Evidence: 3b. Laryngoscope, 2018.

Original languageEnglish (US)
JournalLaryngoscope
DOIs
StateAccepted/In press - Jan 1 2018

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Pharyngeal Muscles
Cadaver
Deglutition Disorders
Esophagoscopy
Laryngoscopes
Food
Laryngoscopy
Fluoroscopy
Deglutition
Respiratory Insufficiency
Cause of Death
Body Mass Index
Cardiovascular Diseases
Demography
Neoplasms

Keywords

  • cricopharyngeus muscle
  • dysphagia
  • esophageal stenosis
  • Pharyngoesophageal segment
  • upper esophageal sphincter

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

The Prevalence of Cricopharyngeal Webs in Elderly Cadavers. / Mehdizadeh, Omid B.; Wickwire, Peter; Said, Mena; Belafsky, Peter C.

In: Laryngoscope, 01.01.2018.

Research output: Contribution to journalArticle

Mehdizadeh, Omid B. ; Wickwire, Peter ; Said, Mena ; Belafsky, Peter C. / The Prevalence of Cricopharyngeal Webs in Elderly Cadavers. In: Laryngoscope. 2018.
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abstract = "Objective: Cricopharyngeal webs (CPW) are a frequent cause of solid food dysphagia. They are difficult to diagnose and are often missed on swallowing fluoroscopy. The prevalence of CPWs is uncertain. The purpose of this study was to determine the prevalence of CPWs in elderly cadavers. Methods: Direct laryngoscopy and cervical esophagoscopy were performed in 19 embalmed cadavers by independent two-clinician consensus. Cadaver demographics and the presence and laterality of a CPW were recorded. The prevalence of CPW was calculated, and the size of the cricopharyngeus muscle (CPM) was quantified. Results: The mean age of the cohort was 83 (± 12) years. Fifty-three percent were female, and the mean body mass index was 19.7 (± 3). The causes of death were cardiovascular disease (10 of 19), cancer (5 of 19), and respiratory failure (4 of 19). A CPW was present in 68{\%} (13 of 19) of cadavers. Forty-seven percent (9 of 19) had a unilateral web, and 21{\%} (4 of 19) had a bilateral web. There was no laterality predominance (P > 0.05). Forty-two percent (8 of 19) had no CPM prominence; 32{\%} (6 of 19) had a small/moderate CPM prominence; and 26{\%} (5 of 19) had a significant CPM prominence. Conclusion: The prevalence of cricopharyngeal webs in elderly cadavers is high (68{\%}). The clinician should maintain a high index of suspicion for CPWs in patients with no other identifiable etiology of solid food dysphagia. Level of Evidence: 3b. Laryngoscope, 2018.",
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N2 - Objective: Cricopharyngeal webs (CPW) are a frequent cause of solid food dysphagia. They are difficult to diagnose and are often missed on swallowing fluoroscopy. The prevalence of CPWs is uncertain. The purpose of this study was to determine the prevalence of CPWs in elderly cadavers. Methods: Direct laryngoscopy and cervical esophagoscopy were performed in 19 embalmed cadavers by independent two-clinician consensus. Cadaver demographics and the presence and laterality of a CPW were recorded. The prevalence of CPW was calculated, and the size of the cricopharyngeus muscle (CPM) was quantified. Results: The mean age of the cohort was 83 (± 12) years. Fifty-three percent were female, and the mean body mass index was 19.7 (± 3). The causes of death were cardiovascular disease (10 of 19), cancer (5 of 19), and respiratory failure (4 of 19). A CPW was present in 68% (13 of 19) of cadavers. Forty-seven percent (9 of 19) had a unilateral web, and 21% (4 of 19) had a bilateral web. There was no laterality predominance (P > 0.05). Forty-two percent (8 of 19) had no CPM prominence; 32% (6 of 19) had a small/moderate CPM prominence; and 26% (5 of 19) had a significant CPM prominence. Conclusion: The prevalence of cricopharyngeal webs in elderly cadavers is high (68%). The clinician should maintain a high index of suspicion for CPWs in patients with no other identifiable etiology of solid food dysphagia. Level of Evidence: 3b. Laryngoscope, 2018.

AB - Objective: Cricopharyngeal webs (CPW) are a frequent cause of solid food dysphagia. They are difficult to diagnose and are often missed on swallowing fluoroscopy. The prevalence of CPWs is uncertain. The purpose of this study was to determine the prevalence of CPWs in elderly cadavers. Methods: Direct laryngoscopy and cervical esophagoscopy were performed in 19 embalmed cadavers by independent two-clinician consensus. Cadaver demographics and the presence and laterality of a CPW were recorded. The prevalence of CPW was calculated, and the size of the cricopharyngeus muscle (CPM) was quantified. Results: The mean age of the cohort was 83 (± 12) years. Fifty-three percent were female, and the mean body mass index was 19.7 (± 3). The causes of death were cardiovascular disease (10 of 19), cancer (5 of 19), and respiratory failure (4 of 19). A CPW was present in 68% (13 of 19) of cadavers. Forty-seven percent (9 of 19) had a unilateral web, and 21% (4 of 19) had a bilateral web. There was no laterality predominance (P > 0.05). Forty-two percent (8 of 19) had no CPM prominence; 32% (6 of 19) had a small/moderate CPM prominence; and 26% (5 of 19) had a significant CPM prominence. Conclusion: The prevalence of cricopharyngeal webs in elderly cadavers is high (68%). The clinician should maintain a high index of suspicion for CPWs in patients with no other identifiable etiology of solid food dysphagia. Level of Evidence: 3b. Laryngoscope, 2018.

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