• 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.

• 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 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.