Effect of cricopharyngeus muscle surgery on the pharynx.
OBJECTIVE
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.


METHODS
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.
Allen
Jacqui
J
Centre for Voice and Swallowing, University of California, Davis, Sacramento, California, USA. jacquieallen@yahoo.com
White
Cheryl J
CJ
Leonard
Rebecca
R
Belafsky
Peter C
PC
D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000503:physiopathology / Q000601:surgery; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000503:physiopathology / Q000601:surgery*; D010609:Pharyngeal Muscles / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D016672:Zenker Diverticulum / Q000503:physiopathology / Q000601:surgery*