Busto-Ruano JP, Pacheco-Ramírez MA, Delgado-González LE, Martínez-Quincosa M

Language: Spanish
References: 10
Page: 53-57
PDF size: 218.66 Kb.

ABSTRACT

Background: The cricopharyngeal muscle together with the inferior constrictor and cervical esophageal fibers make up the upper esophageal sphincter. Resting muscle tone plays critical roles in regulating the opening of the esophagus for swallowing and belching and protects the airway from invasion of gastric or esophageal contents. In the context of the disease, the cricopharyngeal muscle may contract during swallowing due to neurogenic cause or histological changes in the muscle.
Clinical case: An 83-year-old male patient with a 10-year history of dysphagia to solids with progressive weight loss, who went to the emergency room reporting choking on remains of meat that he was unable to expel. During his intervention, an endoscopy was performed, finding remains of food obstructing the upper esophageal sphincter. Subsequently, swallowing test showed a cricopharyngeal bar and aspiration of contrast medium were observed, which is why a cricopharyngeal myotomy was performed. After surgery, a swallowing test was performed again on the patient, where relieve of the condition was observed, finding no cricopharyngeal bar or aspirated contrast fluid.
Conclusions: Cricopharyngeal myotomy should be considered in patients who have primary cricopharyngeal dysfunction characterized by inadequate pharyngeal contraction, lack of coordination between the pharynx and upper esophageal sphincter, or inadequate upper esophageal sphincter relaxation/reduced muscle compliance.

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