• Journal of Veterinary Clinics
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• v.35 no.2
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• pp.50-52
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• 2018

A 6-month-old castrated male poodle presented with a cough, dysphagia, and regurgitation. Cricopharyngeal achalasia (CPA) was diagnosed by clinical history and a fluoroscopic examination. The animal received a botulinum toxin (BTX) injection but symptoms had not resolved by three days after injection. Thus, a cricopharyngeal and thyropharyngeal muscle myotomy was performed and immediately the clinical signs resolved. This report describes successful correction of CPA with myotomy after failure of BTX injection in a dog.

• Journal of Veterinary Clinics
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• v.34 no.4
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• pp.291-294
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• 2017

An 8-month-old Chow-Chow dog presented with dysphagia and regurgitation, and was diagnosed with cricopharyngeal dysphagia (CPD). Cricopharyngeal myotomy did not improve the clinical signs. Three months after the initial surgery, a subtotal myectomy of cricopharyngeal muscle with partial thyropharngeal myotomy was performed. The clinical improvement was maintained for more than one year after the second surgery. Subtotal myectomy of cricopharyngeal muscle can be considered for dogs with CPD that do not respond to myotomy.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.432-435
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• 1998

Idiopathic cricopharyngeal achalasia is a rare condition that produces oropharyngeal dysphagia. It is caused by spasm of the cricopharyngeus and inability to relax with swallowing. A prominent muscle bar at the upper esophageal sphincter is a typical finding of the esophagogram. Cricopharyngeal myotomy is the treatment of choice. We report a case of cricopharyngeal myotomy for 61-year-old female patient.

• Journal of Chest Surgery
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• v.16 no.2
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• pp.260-263
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• 1983

We studied and managed successfully a case of cervical dysphagia, 72 years old male patient. Cervical dysphagia is a relatively uncommon disease and encounters most commonly after the age of sixty in equal sex distribution. The final diagnosis can be made by esophagography and esophagomanometry. We performed cricopharyngeal myotomy of Belsey method with excellent result. After operation patient showed no more dysphagia, normal esophagogram and pressure drop in esophagomanometry.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1991.06a
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• pp.36-36
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• 1991

기도흡인은 후두의 고유기능중 방어기능을 소실함으로써 지속되는 경우 하기도에 치명적인 손상을 초래하게된다. 기도흡인에 대한 치료는 고식적 치료법과 수술적 치료법으로 대별되는데 일반적으로 고식적으로 치료법이 우선적으로 선택되어지고 있으나 흡인의 정도가 심하여 하기도에 폐렴, 무기폐 등의 위급한 합병증을 유발하거나 그 원인이 비가역적이어서 탈진 또는 악액질을 초래하는 경우 부득이 수술적 요법율 선택하게 된다. 수술적 요법의 선택시기에 대하여는 논란이 많으나 현재까지는 고통을 받고있는 환자의 상태에 따라 결정되고 있는 실정에 있다. 저자들은 최근 5년간 경험한 만성 기도흡인 환자 6례에 대하여 수술적 요법 즉, cricopharyngeal myotomy 1례, cricopharyngeal with medialization laryngoplasty 1례, laryngeal suspension with cricopharyngeal myotomy 2례, laryngeal diversion 1례, total laryngectomy 1례를 각각 시행함으로써 얻은 치료경험을 분석 검토하여 만성 기도흡인에 대한 치료상의 문제점과 보다 효율적인 치료법의 선택에 도움을 얻고자 문헌고찰과 함께 보고하는 바이다.

• Proceedings of the KOR-BRONCHOESO Conference
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• 2005.09a
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• pp.20-20
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• 2005

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.52-58
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• 1998

BACKGROUND： Aspiration is defined as the laryngeal penetration of secretions below the level of the true vocal cords. Aspiration can result in life-threatening complications, such as bronchospasm, airway obstruction, pneumonia, pulmonary abscess, sepsis, and death. The patient with high vagal palsy had significant aspiration and dysphagia OBJECTIVE： To formulate a step-by-step management paradign for the patients with high vagal palsy MATERIALS AND METHODS : The medical records of 23 patients who were diagnosed as high vagal palsy from September, 1995 to April, 1998 in Seoul National University Hospital were reviewed retrospectively. Eleven patients were managed conservatively and 12 patients were operated to treat chronic aspiration. RESULTS : The main etiologies of high vagal palsy were mass lesions of the skull base such as neurogenic tumor, pseudotumor, meningioma or nasopharyngeal carcinoma. Aspiration and dysphagia improved in 7 out of 11 patients who were managed conservatively after 2.2 months on the average. The patients who were refractory to the conservative management underwent surgery and showed improvement in 10 out of 12 patients. The employed surgical modalities were vocal cord medialization combined with cricopharyngeal myotomy in 7 patients, laryngotracheal separation in 3 patients and arytenoid adduction only in 2 patients. Two patients still had gastrostomy tube due to the persistent symptoms. Two patients had improved after surgery, but died of underlying disease. CONCLUSION : The patients with high vagal palsy are recommended to be managed conservatively for the first 2 months. If aspiration and dysphagia are persisting after conservative management, vocal cord medialization combined with or without cricopharyngeal myotomy should be considered. If failed, laryngotracheal separation or gastrostomy will be the next option based on the control of the oropharyngeal secretion.

• Korean Journal of Bronchoesophagology
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• v.13 no.2
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• pp.9-16
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• 2007

Cricopharyngeal dysphagia(CPD), a common condition in the dysphagic patient, refers to the dysfunction of the upper esophageal sphincter complex(UESC), which is composed of the cricopharyngeus, inferior pharyngeal constrictor and the upper segment of the cervical esophagus. Primary CPD is the disease entity solely confined to dysfunctional UESC, while secondary CPD encompasses various conditions that accompany UESC dysfunction. For proper diagnosis and treatment of such entity, a thorough understanding of the complex anatomy and physiology of the upper esophageal sphincter. Adequate relaxation of the cricopharyngeal muscle in conjunction with anterosuperior excursion of the larynx by suprahyoid muscles and propulsion of food bolus are prerequisite for normal swallow, mechanisms of which if altered result in cricopharyngeal dysfunction. Of the various methods used for the diagnosis of cricopharyngeal dysphagia, videofluoroscopy remains the method of choice. Mechanical dilatation of the cricopharayngeus, cricopharyngeal myotomy and botulinum toxin injection and head-lift exercise have been used in clinical practice to relieve dysphagia in such patients. Such procedures have therapeutic effect in primary CPD, but so often fail to relieve swallowing dysfunction in patient with secondary CPD. We herein explain ancillary procedures that support these primary treatment options, which lead to successful treatment of dysphagia.

• Journal of Chest Surgery
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• v.49 no.4
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• pp.309-312
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• 2016

A pharyngeal diverticulum is a rare complication of an anterior cervical discectomy and fusion (ACDF). We present a case of a pharyngeal diverticulum after an ACDF, which was misdiagnosed as a typical Zenker diverticulum. A 54-year-old woman presented with dysphagia and a sense of irritation in the neck following C5 through C7 cervical fusion 3 years prior. The patient underwent open surgery to resect the diverticulum with concurrent cricopharyngeal myotomy. An ACDF-related diverticulum is difficult to distinguish from a typical Zenker diverticulum.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.77-81
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• 2019

Dysphagia may result from dysfunction of any of the components involved in the complex neuromuscular interaction of swallowing. Hyperfunction of any of the muscles involved in swallowing is a frequent cause of dysphagia. The cricopharyngeus muscle (CPM) is a key component of the upper esophageal sphincter. Cricopharyngeus muscle dysfunction (CPD) refers to the muscle's failure to appropriately and completely relax or expand during deglutition. A variety of disease processes may cause CPD and accurate diagnosis is paramount for appropriate treatment. In appropriately selected patients, intervention at the CPM may yield significant improvement in dysphagia. Interventions include nonsurgical, pharyngoesophageal segment dilatation, botulinum toxin (BoNT) injection, and criccopharyngeal myotomy. Injections of BoNT in patients with CPD have been reported to result in marked relief of dysphagia. Different techniques for instilling BoNT into the CPM have been described. Awake, in-office CPM BoNT injection with electromyography and/or fluoroscopic or ultrasound guidance is performed transcervically or via flexible endoscopy. Operative CPM BoNT injection involves rigid laryngoscopy and esophagoscopy with direct visualization of the CPM. BoNT should be prepared in low-volume, high-concentration dilutions to minimize the potential for undesired diffusion of the toxin. The effects of BoNT occur within weeks of injection and typically last up to 5 or 6 months.