Abstract:

Cricopharyngeus muscle (CPM) is an important component of upper esophageal sphincter. It is termed cricopharyngeus dysfunction (CPD) if CPM fails to relax, which may be second to neurologic or neoplastic disease. However, the pathogenesis is not yet clear. The diagnosis of CPD would combine clinical features and swallowing evalutions, such as videofluoroscopic swallowing study, pharyngeal manometry and electromyogram, etc. Esophageal manometry is not the golden standard and should be combined with videofluoroscopic swallowing study. Interventions include swallowing exercise, pharyngoesophageal balloon dilatation, Botulinum toxin injection and cricopharyngeus myotomy. The outcomes will be better in those with intact laryngeal elevation and pharyngeal contraction. Balloon dilation is more commonly used. The success rate of cricopharyngeus myotomy is reported higher than that of Botulinum toxin injection. Each of the three technologies has their advantages, and it needs more researches to study their indications, contraindications and patient selection.

Key words: cricopharyngeal dysfunction, pathogenesis, diagnosis, treatment, review