Disorders of the Cricopharyngeus Muscle: A Review

Palmer, Eddy D.

doi:10.1016/s0016-5085(76)80466-0

Cited by 95 publications

(19 citation statements)

References 80 publications

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“…Any indentation into or narrowing of the bolus at the C6/C7 level on sagittal or frontal views should be considered abnormal [8][9][10][11][12][13][14]. Such a finding may not necessarily be symptomatic, since it is present in 5-28% of asymptomatic persons [5,10,13,15].…”

Section: Working Conceptsmentioning

confidence: 99%

Pharyngoesophageal interrelationships: Observations and working concepts

Jones

Ravich

Donner

et al. 1985

Gastrointest Radiol

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Simultaneous disorders of the pharynx and esophagus are so frequent that the complete swallowing chain should be examined in all patients with dysphagia. Data are presented to support the concept that such simultaneous disorders represent related phenomena; the mechanism involves changes in cricopharyngeal function seen radiographically as cricopharyngeal prominence. If neurologic disease has been excluded, cricopharyngeal prominence may be the clue to esophageal disease. When cricopharyngeal prominence is found during dynamic imaging of the pharynx, intensive examination of the esophagus and a search for signs of compensation or decompensation in the pharynx should be undertaken.

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Section: Working Conceptsmentioning

confidence: 99%

Pharyngoesophageal interrelationships: Observations and working concepts

Jones

Ravich

Donner

et al. 1985

Gastrointest Radiol

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“…Obstruction is a common cause of cricopharyngeal dysphagia [1]. The mechanism of the obstruction is not well understood.…”

mentioning

confidence: 99%

“…Using manometry, electromyography, radiography, or combinations of these, many studies have demonstrated that obstruction usually results from complete or incomplete failure of the cricopharyngeus to relax [2], which appears as an impression of the barium column on lateral radiographs of the posterior hypopharyngeal wall and has been termed the cricopharyngeal bar ( Fig. 1a) [1,3,4]. Therefore, if the cricopharyngeus is completely relaxed, such an obstruction should not exist.…”

mentioning

confidence: 99%

Is the Anatomical Protrusion on the Posterior Hypopharyngeal Wall Associated with Cadavers of Only the Elderly?

Wang

et al. 2006

Dysphagia

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Cricopharyngeal bars are commonly seen on a barium swallow radiologic examination and represent the failure of the cricopharyngeus to relax. Traditionally, the bars have been considered as functional or physiologic protrusions. Recently, anatomical cricopharyngeal protrusion has been found in about 30% of cadavers of the elderly, suggesting that such a structural change may become a physical barrier that affects the normal deglutition in a living person. This suggests that such a radiographic finding should be carefully considered when interpreting radiologic and manometrical examinations and managing dysphagia of the elderly. However, the finding of the anatomical cricopharyngeal protrusion was based on the observation of cadavers of the elderly (mean age = 77 years). The aim of this study was to further investigate whether such an anatomical cricopharyngeal protrusion exists in cadavers of other ages. Using the dissection method, we examined 63 human cadavers that were divided into three age groups: young adult (6 females and 10 males, age = 16-24 years old), adult (8 females and 23 males, age = 25-64 years old), and early elderly (5 females and 11 males, age = 65-69 years old). We found that 57 of the 63 cadavers had a smooth mucosal surface on the posterior hypopharyngeal and upper esophageal wall. A slightly thickened posterior muscular wall was observed at the cricoid level in six cadavers (five from the adult group and one from the early elderly group), but its boundary was not clearly identified. Taking the previous reports together, our results suggest that an anatomical cricopharyngeal protrusion is closely associated with the aging process.

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“…It is used in cases where radiography shows defective opening of the pharyngoesophageal segment during the passage of the bolus or increased tonicity at manometry [1][2][3][4][5]. The operation is also performed for Zenker's diverticulum, where premature contraction of the cricopharyngeal muscle is claimed to be of pathogenetic importance [6].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with cervical esophageal webs may also benefit from myotomy. The operation is performed via a lateral approach and using an extramucosal posterior midline incision [3]. Cricopharyngeal myotomy involves the proximal few centimeters of the circular musculature of the cervical esophagus.…”

Section: Discussionmentioning

confidence: 99%

Effect of cricopharyngeal myotomy on pharyngoesophageal function: Pre- and postoperative cineradiographic findings

Ekberg

Lindgren

1987

Gastrointest Radiol

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The pre- and postoperative cineradiographic findings in 14 dysphagic patients who underwent cricopharyngeal myotomy were compared. The reason for the operation was Zenker's diverticulum (7 patients), lack of cricopharyngeal coordination (5 patients), or a cervical esophageal web (2 patients). After the operation the function of the epiglottis, laryngeal vestibule, and pharyngeal constrictors was unaltered (11 patients) or improved (3 patients), although 4 cases showed residual impression due to the cricopharyngeal muscle. Postoperatively, 9 patients developed defective peristalsis and 10 had impaired tonicity of the cervical esophagus. It is concluded that myotomy alters the motor function of the pharyngoesophageal segment considerably. Moreover, certain functions of the pharynx proper are changed by this procedure.

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Disorders of the Cricopharyngeus Muscle: A Review

Cited by 95 publications

References 80 publications

Pharyngoesophageal interrelationships: Observations and working concepts

Pharyngoesophageal interrelationships: Observations and working concepts

Is the Anatomical Protrusion on the Posterior Hypopharyngeal Wall Associated with Cadavers of Only the Elderly?

Effect of cricopharyngeal myotomy on pharyngoesophageal function: Pre- and postoperative cineradiographic findings

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