Cricopharyngeal Achalasia

Abstract

Cricopharyngeal achalasia results from failed relaxation of the upper esophageal sphincter, causing dysphagia and putting patients at risk for aspiration and failure to thrive. Cricopharyngeal achalasia can occur in association with systemic neurologic and muscular issues, but can also occur in isolation. It is encountered only infrequently, and so a comprehensive approach to all patients with dysphagia is imperative. The gold standard for diagnosis of cricopharyngeal achalasia is a videofluoroscopic swallow study. There are a variety of treatment options currently available, each with relative advantages and disadvantages. These include dilatation, Botox injection, and cricopharyngeal myotomy (either transcervical or endoscopic). Though there are risks with the various treatment modalities, they all provide generally favorable outcomes.