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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 sensory thresholds were normal (<4 mm Hg). A fluoroscopic swallow evaluation detected hypertrophy of the cricopharyngeal muscle (figure, A). Manometry of the upper esophageal sphincter 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 OMITTED]

From the Scripps Center for Voice and Swallowing, La Jolla, Calif.
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Title Annotation:Esophagoscopy Clinic
Author:Speirs, Jan
Publication:Ear, Nose and Throat Journal
Article Type:Brief Article
Date:Oct 1, 2003
Words:152
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