Endoscopic myotomy of the cricopharyngeal muscle with CO2 laser surgery.
BACKGROUND
Cricopharyngeal dysfunction may lead to severe dysphagia and aspiration. Several treatment modalities are available, such as external myotomy of the muscle, dilatation, and local infiltration with botulinum toxin. Recently, endoscopic transmucosal myotomies using a CO2 laser have been described.


METHODS
Endoscopic cricopharyngeal myotomy using a CO2 laser was performed in 10 consecutive patients with dysphagia supposedly caused by cricopharyngeal muscle dysfunction without Zenker's diverticulum. All patients received prophylactic antibiotics and a feeding tube. Assessment was composed of clinical observation, a questionnaire, and a physical examination including flexible endoscopy and videofluoroscopy.


RESULTS
In all the patients, the procedure was feasible and without complications. Improvement of the complaints occurred in most patients. One patient had recurrent dysphagia and required a second endoscopic procedure.


CONCLUSIONS
Endoscopic laser surgery seems to be a safe and effective technique to treat cricopharyngeal dysfunction.
Takes
Robert P
RP
Department of Otolaryngology/Head and Neck Surgery, University Medical Center Nijmegen, P. O. Box 9101, 6500 HB Nijmegen, The Netherlands. r.takes@kno.umcn.nl
van den Hoogen
Frank J A
FJ
Marres
Henri A M
HA
D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D004935:Esophageal Diseases / Q000150:complications / Q000601:surgery*; D049631:Esophageal Sphincter, Upper / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014743:Videotape Recording