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Cricopharyngeal myotomy

Jong Myung Park, Chang Wan Kim, Do Hyung Kim
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...
August 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Alexander P Marston, Francisco J Maldonado, Karthik Ravi, Jan L Kasperbauer, Dale C Ekbom
OBJECTIVE: To compare swallowing outcomes following cricopharyngeal (CP) dilation versus surgical myotomy in patients with dysphagia secondary to idiopathic CP bar. METHODS: All patients had an idiopathic CP bar without a history of Zenker's diverticulum, head and neck cancer, or systemic neurologic disease treated between 2000 and 2013. The Functional Outcome Swallowing Scale (FOSS) was utilized to assess dysphagia symptoms. RESULTS: Twenty-three patients underwent 46 dilations and 20 patients had a myotomy...
July 27, 2016: American Journal of Otolaryngology
Emilio Jesús de la Morena Madrigal, Elena Pérez Arellano, Isabel Rodríguez García
INTRODUCTION: Flexible endoscopic treatment is one of the alternative approaches for the management of Zenker's diverticum. The present paper shows our short-term and long-term results with flexible endoscopic cricopharyngeal myotomy/septotomy. PATIENTS AND METHODS: A retrospective analysis of our experience in patients with Zenker's diverticulum treated using a flexible endoscope, assisted by a flexible diverticuloscope, between 2002 and 2015. Myotomy/septotomy was performed with a needle-knife papillotome under deep sedation or general anesthesia...
June 2016: Revista Española de Enfermedades Digestivas
Sruthi S Nair, Arathy Jalaja Surendaran, Jayakumar R Menon, Sapna Erat Sreedharan, Padmavathy N Sylaja
Post-stroke dysphagia is a common problem after stroke. About 8-13% patients have persistent dysphagia and are unable to return to pre-stroke diet even after 6 months of stroke. Use of percutaneous endoscopic gastrostomy (PEG) may be required in these patients, which may be psychologically unacceptable and impair the quality of life. In those with cricopharyngeal dysfunction leading on to refractory post-stroke dysphagia, cricopharyngeal myotomy and injection of botulinum toxin are the treatment options. We present a case of vertebrobasilar stroke who had persistent dysphagia due to cricopharyngeal dysfunction with good recovery of swallowing function following cricopharyngeal myotomy 1...
April 2016: Annals of Indian Academy of Neurology
Diego Juzgado Lucas
The prevalence of Zenker's diverticulum (ZD) is difficult to estimate. If we focus on some published data, it may be as low as 2 new cases per 100,000 inhabitants per year in the United Kingdom, which is in contrast the with feeling in some endoscopy units, that this condition's prevalence is increasing year after year. Prevalence likely remains the same as ever, but the addition of factors such as population ageing, optimal diagnostic care, availability of effective endoscopic management, increased awareness, and cumulative experience in some endoscopy teams, may well have increasingly brought this condition to our attention in our daily practice...
June 2016: Revista Española de Enfermedades Digestivas
D M Beswick, E J Damrose
OBJECTIVE: To evaluate the utility of the hybrid tracheoesophageal puncture procedure in stapler-assisted laryngectomy. METHODS: Patients who underwent total laryngectomy at a single institution from 2009 to 2015 were reviewed. The interventions assessed were surgical creation of a tracheoesophageal puncture and placement of a voice prosthesis. The outcomes measured included voicing ability and valve failure. RESULTS: Thirty-nine patients underwent total laryngectomy or pharyngolaryngectomy...
July 2016: Journal of Laryngology and Otology
A Ashman, O T Dale, D L Baldwin
OBJECTIVE: A systematic review was performed to evaluate the safety and efficacy of different therapeutic interventions available for the management of isolated cricopharyngeal dysfunction. METHODS: Studies were identified using the following databases: Ovid (Medline, Embase), the Cochrane Library, PubMed and Google Scholar. An initial search identified 339 articles. All titles and abstracts were reviewed. Fifty-six relevant articles were inspected in more detail; of these, 47 were included in the qualitative analysis...
July 2016: Journal of Laryngology and Otology
Nancy Jiang, C Kwang Sung, Edward J Damrose
OBJECTIVES: Gastroesophageal reflux may contribute to the development of cricopharyngeal dysfunction and Zenker's diverticulum. Common dictum suggests that if upper esophageal sphincter tone is reduced through cricopharyngeal myotomy, symptoms of laryngopharyngeal reflux may worsen. We hypothesized that patients who undergo myotomy should show decreased dysphagia symptoms with concurrent worsening of reflux symptomatology and that these changes would be greater in those patients undergoing complete versus partial myotomy...
April 1, 2016: Journal of Voice: Official Journal of the Voice Foundation
Rupali N Shah, Keimun A Slaughter, Lauren W Fedore, Benjamin Y Huang, Allison M Deal, Robert A Buckmire
OBJECTIVES/HYPOTHESIS: We aimed to compare three surgical techniques (open approach for diverticulectomy with cricopharyngeal myotomy [OA], endoscopic laser-assisted diverticulotomy [ELD], and endoscopic stapler-assisted diverticulotomy [ESD]) for treatment of Zenker's diverticulum with regard to validated swallowing outcomes, radiographic outcomes, complications, and revision rates. We statistically analyzed whether the size of residual postoperative party wall or the specific surgical technique correlates with swallowing outcomes...
March 24, 2016: Laryngoscope
Daniel Jones, Abdullah Aloraini, Stephen Gowing, Jonathan Cools-Lartigue, Mara Leimanis, Roger Tabah, Lorenzo Ferri
BACKGROUND: Open surgical cricopharyngeal myotomy(CM) is considered standard of care for Zenker's diverticulum(ZD). Trans-oral CM has been described using a rigid stapling device for two decades; however, this remains problematic for severely kyphotic patients. This problem can be overcome with flexible endoscopy utilizing an electrosurgical needle knife. We sought to compare clinical outcomes between these techniques to stratify patient selection. METHODS: Patients undergoing ZD treatment from 1992 to 2015 were reviewed...
June 2016: World Journal of Surgery
Arta Hoesseini, Jimmie Honings, Rabia Taus-Mohamedradja, Frank J A van den Hoogen, Henri A M Marres, Guido B van den Broek, Hanneke Kalf, Robert P Takes
BACKGROUND: Endoscopic cricopharyngeal myotomy (ECPM) using CO2 laser surgery presents a less invasive treatment technique when compared to transcervical cricopharyngeal myotomy. METHODS: Forty-seven patients who underwent ECPM from 2002 until 2013 were included in this study. Patient characteristics, and preoperative and postoperative outcome and complications were scored by retrospective chart review and by using the Deglutition Handicap Index (DHI). RESULTS: Overall, 40 of 47 patients (85%) experienced relief of symptoms postoperatively...
July 2016: Head & Neck
Dylan Lippert, Matthew R Hoffman, Christopher J Britt, Corinne A Jones, Jodi Hernandez, Michelle R Ciucci, Timothy M McCulloch
INTRODUCTION: Understanding of swallowing pressures after total laryngectomy (TL) and what constitutes a "functional" swallow are limited. Mobile structures are altered or removed after TL, with consequent effects on pressure profiles. High-resolution manometry (HRM) can characterize these pressures. METHODS: Six TL subjects without dysphagia and 6 controls underwent pharyngeal HRM. Timing and pressure variables for the velopharynx, mesopharynx, and upper esophageal sphincter (UES) were compared...
July 2016: Annals of Otology, Rhinology, and Laryngology
José Luis Braga de Aquino, José Francisco Salles Chagas, Marcelo Manzano Said, Maria Beatriz Nogueira Pascoal, Luis Antonio Brandi-Filho, Douglas Alexandre Rizzanti Pereira, Fernanda Fruet
BACKGROUND: The occurrence of the pharyngoesophageal, or Zenker diverticulum is not frequent in the national scenario, and the technique of the diverticulectomy with cricomyotomy in medium and great dimension diverticula is still the most indicated. Because the resection of the diverticulum requires the suture of the pharynx, dehiscence can occur, thereafter delaying swallowing. Hence, the idea is to accomplish this surgical procedure, comparing the manual and mechanical suture, in order to evaluate the real benefit of the mechanical technique...
November 2015: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
B Jackson, Z Ahmad, R P Morton
OBJECTIVE: To evaluate our results in treating Zenker's diverticulum via the transcervical approach, and to compare our experiences with a recent systematic review of both open and endoscopic approaches to the pharyngeal pouch. METHOD: An audit yielded 41 consecutive cases of Zenker's diverticulum treated between 2003 and 2013. RESULTS: All 41 patients underwent transcervical cricopharyngeal myotomy; 29 sacs also required 'inversion'. The median and mean length of hospital stay was 1 night and 2...
January 2016: Journal of Laryngology and Otology
Kathryn M Van Abel, Nicole M Tombers, Kari A Krein, Eric J Moore, Daniel L Price, Jan L Kasperbauer, Michael L Hinni, David G Lott, Dale C Ekbom
OBJECTIVE: To prospectively analyze quality-of-life outcomes following transoral diverticulotomy with cricopharyngeal myotomy (DCPM) for Zenker's diverticulum (ZD). STUDY DESIGN: Prospective single-group study. SETTINGS: Tertiary academic institution. SUBJECTS AND METHODS: A prospective multicenter study performed from January 1, 2012, to July 1, 2014, included 18 patients presenting with ZD undergoing DCPM. Standardized questionnaires-including the 10-item Eating Assessment Tool (EAT-10), Functional Outcome of Swallowing Scale (FOSS), and the Reflux Symptom Index (RSI)-were completed preoperatively and at 3 and 6 months postoperatively...
February 2016: Otolaryngology—Head and Neck Surgery
Gianluigi Melotti, Micaela Piccoli, Barbara Mullineris, Michele Varoli, Giovanni Colli, Davide Gozzo, Nazareno Smerieri, Narne Surendra, Angelo Caruso, Rita Conigliaro, Marzio Frazzoni
Standard surgical treatment of Zenker's diverticulum consists of open cricopharyngeal myotomy with diverticulectomy. A rigid or flexible endoscopic approach allowing a cricopharyngeal myotomy without diverticulectomy is currently considered as a less invasive alternative to open surgery with reportedly comparable symptom relief at short term follow-up. In recent years, high safety and efficacy of a transaxillary gasless robotic access to the thyroid gland has been shown. The present study describes the feasibility and preliminary results of robot-assisted transaxillary approach for cricopharyngeal myotomy and excision of Zenker's diverticulum...
March 2015: Journal of Robotic Surgery
Pelin Kocdor, Eric R Siegel, Ozlem E Tulunay-Ugur
OBJECTIVES: Cricopharyngeal dysfunction may lead to severe dysphagia and aspiration. The objective of this systematic review was to evaluate the existing studies on the effectiveness of myotomy, dilatation, and botulinum toxin (BoT) injection in the management of cricopharyngeal dysphagia. METHODS: PubMed and Web of Science databases were searched to identify eligible studies by using the terms "cricopharyngeal dysfunction," "cricopharyngeal myotomy," "cricopharyngeal botox," "cricopharyngeal dilation," and their combinations from 1990 to 2013...
January 2016: Laryngoscope
Radu Pescarus, Eran Shlomovitz, Ahmed M Sharata, Maria A Cassera, Kevin M Reavis, Christy M Dunst, Lee L Swanström
INTRODUCTION: Zenker's diverticulum (ZD) is a rare upper esophageal pathology that is most prevalent in the sixth and seventh decade. Three different therapeutical options are available: (1) open trans-cervical approach, (2) rigid endoscopy and (3) flexible endoscopy. Our hypothesis is that a flexible endoscopic cricomyotomy represents a safe and effective treatment of ZD as well as cricopharyngeal spasm. METHODS: A retrospective analysis of all patients that underwent a flexible endoscopic cricomyotomy at our institution between October 2008 and May 2014 was performed...
May 2016: Surgical Endoscopy
Beatriz Arenaz Búa, Rolf Olsson, Ulla Westin, Roland Rydell, Olle Ekberg
BACKGROUND: Cricopharyngeal dysfunction is a narrowing at the level of the upper oesophageal sphincter caused by failed or incomplete sphincter opening as a result of lack of pharyngoesophageal coordination or reduction in the muscular compliance of the upper oesophageal sphincter. Oropharyngeal dysphagia is a typical symptom. Videomanometry allows direct comparison of pressure readings with dynamic anatomy during swallowing. METHODS: This is a prospective randomized pilot study that compares the effect of balloon dilatation and laser myotomy in cricopharyngeal dysfunction...
2015: BMC Research Notes
Luis F Lara, Tolga Erim, Ronnie Pimentel
No abstract text is available yet for this article.
August 2015: Gastrointestinal Endoscopy
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