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The Journal of Thoracic and Cardiovascular Surgery, Vol 98, 428-433, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Myotomy for reflux-induced cricopharyngeal dysphagia. Five-year review

RD Henderson, WM Hanna, RF Henderson and G Marryatt
Department of Surgery, University of Toronto, Women's College Hospital, Ontario, Canada.

This report describes 25 patients with reflux-induced cricopharyngeal dysphagia ultimately requiring surgical management. Eighteen patients underwent cricopharyngeal myotomy alone and seven patients required cricopharyngeal myotomy after an antireflux operation failed to correct this symptom. Cricopharyngeal incoordination was demonstrated at manometry in over 90% of patients. Treatment included cricopharyngeal myotomy, which was extended proximally to the pharynx and distally to the intrathoracic esophagus. Results were excellent to satisfactory in 24 of 25 patients. Pathologic examination of the cricopharyngeal muscle demonstrated a wide variety of myopathic degenerative changes. We stress that cricopharyngeal myotomy may be performed even in the presence of reflux without fear of subsequent aspiration.




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Copyright © 1989 by The American Association for Thoracic Surgery.