cricopharyngeal muscle spasm

Cricopharyngeal

myotomy for cricopharyngeus muscle dysfunction after esophagectomy. Swallow functional test before cricopharyngeal myotomy. a Laryngeal penetration occurred during laryngeal elevation in the pharyngeal phase. b The bolus did not pass entirely through the upper esophageal sphincter in the esophageal phase. c Breathing was reinitiated with a massive amount of pharyngeal residue. Yellow arrow; Hyoid bone, Blue arrow; Esophageal orifice

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Cricopharyngeal muscle spasm is also known as cricopharyngeal achalasia, although some authors distinguish between these entities, and may present as a cause of dysphagia.

Terminology

There is confusing use of the terms cricopharyngeal muscle spasm, cricopharyngeal achalasia and cricopharyngeal bar.

Cricopharyngeal bar refers to the radiographic appearance of a prominent cricopharyngeus muscle contour but is not synonymous with cricopharyngeal muscle spasm/achalasia, which is one of the underlying pathologies that can cause the appearance of one.

Pathology

In most patients the exact etiology for this spasm is unknown. Some associated predisposing conditions include:

Radiographic features

Fluoroscopy

Presents as a cricopharyngeal bar, which is seen as a relatively constant impression on the posterior aspect of esophagus at C5-6 level. Cricopharyngeal spasm can be diagnosed with manometry.