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Cricopharyngeal Dysfunction

When a person swallows, the food passes through a muscle called the cricopharyngeus. The cricopharyngeus muscle remains tight until the person swallows, at which point it should relax.
With cricopharyngeal dysfunction, however, the muscle doesn’t relax, and the food becomes blocked.

● Symptoms of cricopharyngeal dysfunction involve difficulty swallowing solid foods. Often, patients may have drastically changed their diet in order to cope with the disorder and are eating only very soft or pureed foods. (see “Presentation/Symptoms” video below)
● Diagnosis: A visual examination of the patient’s throat will often reveal some food or saliva pooling in the back of the throat. Physicians can also test the pressure and function of the muscle using a manometer - a catheter that’s passed through a patient's nose into the esophagus. A Barium study, in which the patient swallows some barium-coated food or liquid, can also be performed to determine whether or not the muscle is relaxing. (see “Diagnosis” video below)
● Treatment: To treat the muscle, physicians can temporarily paralyze it by injecting it with Botox. However, the definite treatment is a surgical procedure in which the muscle is cut, relaxing it so that it no longer blocks food entry into the esophagus when the patient swallows. The more traditional procedure is open surgery through the neck, but a newer endoscopic procedure, performed through the mouth, offers a faster recovery and may be safer than traditional surgery. (see “Treatment” video below)
● Prognosis: If the rest of the swallowing mechanism is normal, then treating the muscle will almost always result in the return of normal swallowing function. If a lot of the swallowing mechanism is abnormal, however, then the decision to treat the muscle is more complicated and requires a long discussion with the physician. (see “Prognosis” video below)

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