Open and endoscopic cricopharyngeal myotomy

Abstract

Cricopharyngeal myotomy is a recognized treatment for disorders of the pharyngoesophageal junction. The etiology of these disorders is either neurologic, muscular, idiopathic, iatrogenic or may result from distal esophageal dysfunction or obstruction. Independently of the cause for the abnormal function, the operation aims at improving bolus transport from pharynx to cervical esophagus. Indications investigation and the open approach technique are described with the rationale for the operation. The clinical and functional results are discussed for each category of dysfunction. The recent literature emphasizes the advent of minimally invasive surgery to remove the obstructive effects of the upper esophageal sphincter. The vast majority of these operations are now reported for the pharyngoesophageal diverticulum. However, endoscopic Cricopharyngeal myotomy has now been performed for Cricopharyngeal dysfunction. This chapter aims at reviewing the results of both the open or endoscopic Cricopharyngeal myotomy to treat oropharyngeal dysphagia.