Faculty Collaboration Database

The risk and complications of aspiration following cricopharyngeal myotomy. Am J Med 1997 Nov 24;103(5A):61S-63S

Date

01/09/1998

Pubmed ID

9422626

DOI

10.1016/s0002-9343(97)00325-2

Scopus ID

2-s2.0-0031463418 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

This article reviews a series of patients undergoing cricopharyngeal myotomy and determines whether clinically dangerous aspiration is seen postoperatively. A total of 23 patients underwent myotomy. Indications included Zenker's diverticulum (14), anticipated or real dysphagia from skull base lesions (5), dysphagia from stroke (2), and dysphagia from glossectomy and radiation therapy (2). Surgical procedures, complications, and effectiveness were reviewed. Of patients with Zenker's diverticula, 13 of 14 had clinically useful improvement in dysphagia. Of patients with skull base lesions, all 5 had improvement (4 of these also had thyroplasites and cervical plexus-to-superior laryngeal nerve anastomoses). Of the patients with strokes, neither had significant improvement. Of the patients with glossectomy and radiation, 1 had useful improvement. Complications were seen in 5 patients: 2 had self-limiting pharyngeal leaks, and 3 had pneumonia 1-4 months postoperatively. One patient also had a postoperative ipsilateral recurrent laryngeal nerve injury. There were no postoperative deaths. In conclusion, cricopharyngeal myotomy has definite utility in the management of cervical dysphagia, even though the etiology of the dysphagia can be multifactorial. Risks directly attributable to the procedure are usually self-limiting; serious complications are usually associated with the underlying disease. The addition of adjunctive procedures, such as thyroplasty and superior laryngeal nerve reinnervation, may be of additional benefit to patients with high extracranial vagal injuries.

Author List

Campbell BH, Tuominen TC, Toohill RJ

Author

Bruce H. Campbell MD Emeritus Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Cricoid Cartilage
Deglutition Disorders
Female
Humans
Male
Middle Aged
Pharyngeal Muscles
Postoperative Complications
Retrospective Studies
Risk
Risk Factors
Surgical Procedures, Operative
Treatment Outcome