Abstract
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. SUMMARY BACKGROUND DATA: 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.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Asoh R., Goyal R. K. Manometry and electromyography of the upper esophageal sphincter in the opossum. Gastroenterology. 1978 Mar;74(3):514–520. [PubMed] [Google Scholar]
- Bonavina L., Khan N. A., DeMeester T. R. Pharyngoesophageal dysfunctions. The role of cricopharyngeal myotomy. Arch Surg. 1985 May;120(5):541–549. doi: 10.1001/archsurg.1985.01390290023004. [DOI] [PubMed] [Google Scholar]
- Cook I. J., Dodds W. J., Dantas R. O., Massey B., Kern M. K., Lang I. M., Brasseur J. G., Hogan W. J. Opening mechanisms of the human upper esophageal sphincter. Am J Physiol. 1989 Nov;257(5 Pt 1):G748–G759. doi: 10.1152/ajpgi.1989.257.5.G748. [DOI] [PubMed] [Google Scholar]
- Cook I. J., Gabb M., Panagopoulos V., Jamieson G. G., Dodds W. J., Dent J., Shearman D. J. Pharyngeal (Zenker's) diverticulum is a disorder of upper esophageal sphincter opening. Gastroenterology. 1992 Oct;103(4):1229–1235. doi: 10.1016/0016-5085(92)91508-2. [DOI] [PubMed] [Google Scholar]
- Curtis D. J., Cruess D. F., Berg T. The cricopharyngeal muscle: a videorecording review. AJR Am J Roentgenol. 1984 Mar;142(3):497–500. doi: 10.2214/ajr.142.3.497. [DOI] [PubMed] [Google Scholar]
- Duranceau A. C., Jamieson G. G., Beauchamp G. The technique of cricopharyngeal myotomy. Surg Clin North Am. 1983 Aug;63(4):833–839. doi: 10.1016/s0039-6109(16)43084-7. [DOI] [PubMed] [Google Scholar]
- Duranceau A. C., Jamieson G. G., Beauchamp G. The technique of cricopharyngeal myotomy. Surg Clin North Am. 1983 Aug;63(4):833–839. doi: 10.1016/s0039-6109(16)43084-7. [DOI] [PubMed] [Google Scholar]
- Duranceau A., Lafontaine E. R., Taillefer R., Jamieson G. G. Oropharyngeal dysphagia and operations on the upper esophageal sphincter. Surg Annu. 1987;19:317–362. [PubMed] [Google Scholar]
- Ellis F. H., Jr, Crozier R. E. Cervical esophageal dysphagia: indications for and results of cricopharyngeal myotomy. Ann Surg. 1981 Sep;194(3):279–289. doi: 10.1097/00000658-198109000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ellis F. H., Jr, Schlegel J. F., Lynch V. P., Payne W. S. Cricopharyngeal myotomy for pharyngo-esophageal diverticulum. Ann Surg. 1969 Sep;170(3):340–349. doi: 10.1097/00000658-196909010-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Goyal R. K., Martin S. B., Shapiro J., Spechler S. J. The role of cricopharyngeus muscle in pharyngoesophageal disorders. Dysphagia. 1993;8(3):252–258. doi: 10.1007/BF01354547. [DOI] [PubMed] [Google Scholar]
- Kahrilas P. J., Dodds W. J., Dent J., Haeberle B., Hogan W. J., Arndorfer R. C. Effect of sleep, spontaneous gastroesophageal reflux, and a meal on upper esophageal sphincter pressure in normal human volunteers. Gastroenterology. 1987 Feb;92(2):466–471. doi: 10.1016/0016-5085(87)90143-0. [DOI] [PubMed] [Google Scholar]
- Kahrilas P. J., Dodds W. J., Dent J., Logemann J. A., Shaker R. Upper esophageal sphincter function during deglutition. Gastroenterology. 1988 Jul;95(1):52–62. doi: 10.1016/0016-5085(88)90290-9. [DOI] [PubMed] [Google Scholar]
- Knuff T. E., Benjamin S. B., Castell D. O. Pharyngoesophageal (Zenker's) diverticulum: a reappraisal. Gastroenterology. 1982 Apr;82(4):734–736. [PubMed] [Google Scholar]
- Sokol E. M., Heitmann P., Wolf B. S., Cohen B. R. Simultaneous cineradiographic and manometric study of the pharynx, hypopharynx, and cervical esophagus. Gastroenterology. 1966 Dec;51(6):960–974. [PubMed] [Google Scholar]
- Taillefer R., Duranceau A. C. Manometric and radionuclide assessment of pharyngeal emptying before and after cricopharyngeal myotomy in patients with oculopharyngeal muscular dystrophy. J Thorac Cardiovasc Surg. 1988 May;95(5):868–875. [PubMed] [Google Scholar]
- Vanner R. G., Pryle B. J., O'Dwyer J. P., Reynolds F. Upper oesophageal sphincter pressure during inhalational anaesthesia. Anaesthesia. 1992 Nov;47(11):950–954. doi: 10.1111/j.1365-2044.1992.tb03196.x. [DOI] [PubMed] [Google Scholar]
- Zaino C., Jacobson H. G., Lepow H., Ozturk C. The pharyngoesophageal sphincter. Radiology. 1967 Oct;89(4):639–645. doi: 10.1148/89.4.639. [DOI] [PubMed] [Google Scholar]
