Sleeve recording of upper esophageal sphincter resting pressures during cricopharyngeal myotomy.
OBJECTIVE
The manometric effects of a 6-cm cricopharyngeal myotomy are recorded while the operation is being performed from cervical esophagus to the cricopharyngeus and then to the hypopharynx.


BACKGROUND
Cricopharyngeal myotomy is used in the treatment of oropharyngeal dysphagia of different causes. The operation decreases the resting pressure in the upper esophageal sphincter (UES). The components responsible for this decrease have not been clarified.


METHODS
Fourteen patients with oropharyngeal dysphagia underwent a sleeve recording of the UES resting pressures under general anesthesia before and after sequential myotomy of the pharyngoesophageal junction. Patients were assessed in the awake state before and after the whole myotomy.


RESULTS
Upper esophageal pressures remain unchanged after division of 2 cm of the cervical esophageal muscle. Section of 2 cm of the cricopharyngeal area results in a significant decrease of the sphincter resting pressure (p < 0.01). The division of 2 cm of hypopharyngeal muscle results in a further significant reduction of the resting pressure (p < 0.005).


CONCLUSIONS
Extension of the cricopharyngeal myotomy over hypopharyngeal musculature produces a more significant decrease of UES resting pressure.
Pera
M
M
Department of Surgery, Université de Montréal, Hôtel-Dieu de Montréal, Québec, Canada.
Yamada
A
A
Hiebert
C A
CA
Duranceau
A
A
D000368:Aged; D000369:Aged, 80 and over; D003413:Cricoid Cartilage / Q000601:surgery; D003680:Deglutition Disorders / Q000503:physiopathology* / Q000601:surgery*; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D010614:Pharynx / Q000601:surgery; D011312:Pressure