Cricopharyngeal Dysfunction

The cricopharyngeus muscle is located at the bottom of the throat, between the throat and the esophagus. This muscle is normally contracted, preventing the reflux of foods from the esophagus into the throat. 

The cricopharyngeus muscle normally relaxes during swallowing, allowing food and liquids to pass easily from the throat into the esophagus. However, often with aging, the muscle may have difficulty relaxing.

Symptoms of cricopharyngeal dysfunction or hypertrophy include:

Difficulty swallowing
Difficulty passing solids
Feeling that food is stuck in the throat

Diagnosis of cricopharyngeal dysfunction may be obtained with:

Complete head and neck examination
Laryngoscopy
Esophagoscopy
Esophagogram
Modified Barium Swallow Study

Treatment of this disorder may involve dietary modifications, although this does not cure the condition.

A dilation, or stretching of the esophagus and cricopharyngeus muscle,  may temporarily improve symptoms, although the muscle tightening may return.

Botox may be used to temporarily relax the muscle. Botox is placed through an injection in the neck and lasts for 3-6 months depending on the patient and the dose used.

The muscle itself may be cut. 

Cricopharyngeus muscle myotomy is the term to describe cutting this muscle. This can be performed outside through the neck. 

Cricopharyngeus muscle myotomy may be performed in a minimally invasive fashion, using a laser that is manipulated through the mouth. The laser is used to cut the muscle, preventing over-contraction, and resolving a patient’s symptoms.  Alternatively an incision may be made on the neck and the cricopharyngeus muscle cut from the outside.