Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-23T11:37:09.099Z Has data issue: false hasContentIssue false

Cricopharyngeal dysfunction with significant piriform sinus expansion: case report

Published online by Cambridge University Press:  22 May 2009

S Chitose*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
H Umeno
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
S Hamakawa
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
K Gondou
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
T Nakashima
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
*
Address for correspondence: Dr Shunichi Chitose, Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. Fax: +81 942 37 1200 E-mail: [email protected]

Abstract

This report describes the case of a patient with cricopharyngeal dysfunction with significant piriform sinus expansion. An 80-year-old man presented with a three-year history of dysphagia. Palsy of the cricopharyngeal chalasis was identified by electromyography under both videofluorography and manofluorography. Although a widening procedure was performed in the cricopharyngeal region using a bougie, the patient gained only minor relief from his dysphagia. After the patient had had adequate time to recover spontaneously (six months), a cricopharyngeal myotomy was performed. As a result, his dysphagia resolved and the post-operative course was uneventful. The clinical and histopathological findings in this case suggested that significant piriform sinus expansion had resulted from the cricopharyngeal dysfunction, due to cricopharyngeal myopathy.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Logemann, JA. Evaluation and Treatment of Swallowing Disorders. Austin, Texas: Pro-Ed, 1998;233Google Scholar
2Yoshida, T. Electromyographic and X-ray investigations of normal deglutition. Otologia Fukuoka 1979;25:824–72Google Scholar
3Yokoyama, M, Mitomi, N, Tetsuka, K, Tayama, N. Study of normal swallowing by simultaneous video recording of fluoroscopy and manometry. J Jpn Bronchoesophagol Soc 1998;49:249–58CrossRefGoogle Scholar
4Reichert, TJ, Bluestone, CD, Stool, SE, Sieber, WK, Sieber, AM. Congenital cricopharyngeal achalasia. Ann Otol 1977;86:603–10Google ScholarPubMed
5Hirano, M, Ohkubo, H, Yoshida, T, Esaki, S, Yoshida, Y, Shin, T. Does the clinical entity called “cricopharyngeal achalasia” exist? J Jpn Bronchoesophagol Soc 1981;32:365–72CrossRefGoogle Scholar
6Cruse, JP, Edwards, DAW, Smith, JF, Wyllie, JH. The pathology of a cricopharyngeal dysphagia. Histopathology 1979;3:223–32CrossRefGoogle ScholarPubMed
7Murofushi, T, Nagao, Y, Semba, T, Mizuno, M, Niimi, S, Hirose, H. A histopathological study of the cricopharyngeus muscle. J Jpn Bronchoesophagol Soc 1987;38:283–9CrossRefGoogle Scholar
8Mori, T, Fukui, K, Hyodo, M, Kawakita, S, Kadota, Y, Inagi, S et al. A histopathological study of the cricopharyngeus muscle of patients with dynamic swallowing disorders. Larynx Jpn 1994;6:1923CrossRefGoogle Scholar
9Fujishima, I, Hojo, K, Ohkuma, R, Shibamoto, I, Kojima, C, Tanaka, S et al. Balloon catheter treatment methods for cricopharyngeal dysphagia. Otologia Fukuoka 1999;45:147–51Google Scholar