Treatment of Cricopharyngeal Dysfunction by Endoscopic Laser Myotomy

Abstract

Cricopharyngeal dysfunction may be caused by a central or peripheral nerve disease, a muscular disease, previous neck surgery or it may be idiopathic. The treatment may be a myotomy of the cricopharyngeal muscle carried out externally or endoscopically. Since 1995 we have treated 17 patients with endoscopic myotomy of the cricopharyngeal muscle with the CO 2 laser. Anamnesis was the basis for the diagnosis and we obtained further information from videoradiographs of the upper gastrointestinal tract and from manometry. There were no immediate or late complications from the surgery. Three patients died from other diseases, the remaining 14 patients were sent a follow-up questionnaire and asked to grade their complaints pre- and postoperatively and to answer questions about their weight. All patients except one stated that their swallowing abilities had improved since the surgery and more than half of the patients had gained weight. A low rate of complications and postoperative morbidity, combined with good functional results, indicate that endoscopic laser myotomy should be recommended for treatment of cricopharyngeal dysfunction.