The frequency of cricopharyngeal dysfunction on videofluoroscopic swallowing studies in patients with dysphagia.
OBJECTIVE
Dysphagia associated with cricopharyngeal dysfunction (CPD) is of particular interest to the otolaryngologist because it may respond to cricopharyngeal myotomy. There is a wide variation in the reported incidence of cricopharyngeal dysfunction in patients with dysphagia. This can be attributed to the different populations being studied, the lack of uniform criteria for diagnosis, and to different techniques used to evaluate patients. We have reviewed videofluoroscopic swallowing studies (VSS) conducted on 443 consecutive patients with complaints of dysphagia to identify the incidence of cricopharyngeal dysfunction.


METHODS
The patient population consists of 443 veterans with complaints of dysphagia who were evaluated by videofluoroscopic swallowing studies at the Department of Veterans Affairs Medical Center, East Orange, NJ, between November 1988 and March 1993.


RESULTS
Cricopharyngeal dysfunction was diagnosed radiologically as the appearance of a shelf in the posterior column of barium at the level of the cricoid cartilage. It was identified in 10 of 177 (5.7%) patients with neurological disorders, in 7 of 142 (4.9%) patients with head and neck or esophageal tumors, and in 11 of 124 (8.9%) patients with other medical problems.


CONCLUSIONS
These results do not support the notion that cricopharyngeal dysfunction is an important factor in a significant proportion of patients with dysphagia. It is recognized that videofluoroscopy may not always detect cricopharyngeal dysfunction and that better criteria for identifying this entity are needed.
Baredes
S
S
Section of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry-New Jersey Medical School, Newark 07103, USA.
Shah
C S
CS
Kaufman
R
R
D000328:Adult; D000368:Aged; D001464:Barium; D003679:Deglutition; D003680:Deglutition Disorders / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D005471:Fluoroscopy; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D009422:Nervous System Diseases / Q000150:complications; D010609:Pharyngeal Muscles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D013690:Television; D014728:Veterans
D001464:Barium