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Endoscopic cricopharyngeal myotomy is a safe and effective treatment option for patients with cricopharyngeus dysphasia. This was due to weakness in the inferior pharyngeal constrictor and/or an abnormal timing of the peristalsis whereby contraction of the cricopharyngeus occurred before peristalsis in the inferior pharyngeal constrictor had cleared the pharynx of barium. In doubtful cases manofluorography and electromyography should be performed. The development of new devices has enhanced the procedure's efficacy and the overall success rate without major complications.ĭiagnosis of cricopharyngeus dysfunction is based on anamnesis and videoradiograph findings. Transoral cricopharyngeal myotomy for the treatment of cricopharyngeus dysmotility is now established as a safe and effective method. Ambulatory 24 h double probe pH monitoring and the triple sensor combination pH test demonstrate clinical correlation between pH results and symptoms in patients suffering from dysphagia related to laryngopharyngeal reflux. Electromyographic activity of the inferior pharyngeal constrictor and cricopharyngeus recorded by transcutaneous electrodes at rest and during deglutition has shown different dysfunction patterns. Isolated cricopharyngeus dyscoordination, however, is not easily identified using this method. Manofluorography appears to be more accurate in detecting intrabolus pressure anomalies during swallowing. Several investigations have provided pertinent information on selecting patients for cricopharyngeal myotomy. This review examines recent surgical management of cricopharyngeus dysmotility. Several reports emphasize the benefits of the endoscopic approach compared with the transcervical technique. Cricopharyngeal muscle myotomy to treat swallowing disorders has a definite role in the management of cervical dysphagia.
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