Endoscopic cricopharyngeal myotomy.A 53-year-old man came to us with a 7-year history of dysphagia for solids and liquids, which had caused him to lose 22 lbs over the preceding 3 years. He was otherwise healthy. A fiberoptic endoscopic evaluation of his swallowing with sensory testing revealed some pooling of puree and solid food in the piriform sinuses; findings on the remainder of the examination were unremarkable. Laryngeal laryngeal /lar·yn·ge·al/ (lah-rin´je-al) pertaining to the larynx. la·ryn·geal or la·ryn·gal adj. Of, relating to, affecting, or near the larynx. sensory thresholds were normal (<4 mm Hg). A fluoroscopic Fluoroscopic (fluoroscopy) An x-ray procedure that produces immediate images and motion on a screen. The images look like those seen at airport baggage security stations. Mentioned in: Hypotonic Duodenography swallow evaluation detected hypertrophy of the cricopharyngeal muscle (figure, A). Manometry manometry /ma·nom·e·try/ (-e-tre) the measurement of pressure by means of a manometer. anal manometry of the upper esophageal sphincter The upper esophageal sphincter (UES) refers to the superior portion of the esophagus. Unlike the lower esophageal sphincter, it is comprised of striated muscle and is under conscious control. revealed a high resting pressure (160 mm Hg) with poor relaxation (residual pressure: 20 mm Hg). The patient underwent an endoscopic cricopharyngeal myotomy with the carbon dioxide (C[O.sub.2]) laser (figure, B and C). Postoperatively, he experienced complete relief of his dysphagia and is now symptom-free. [FIGURES A-C A-C Air Conditioning OMITTED] From the Scripps Center for Voice and Swallowing, La Jolla, Calif. |
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