[Pharyngeal constrictors and deglutition (apropos of 4 cases]

The authors describe four cases of deglutition disorders, even resulting in aphagia in two cases, in which the constrictor muscles of the pharynx were quite clearly entirely responsible. Electromanometry made diagnosis possibe for these patients and it is the only method capable of distinguishing crico-pharyngeal achalasis from paralysis of the constrictor muscles. The authors draw attention to the fundamental importance of this method of investigation in the pathology of deglutition. The propellent role of the constrictors, emphasized by some authors, rather than the upthrust of the tongues seems to be the borne theory out by these cases. Despite surgical ablation as recommended by most authors, or the spontaneous pathological disappearance of the crico-pharyngeal, the condition of the patients described was not improved; therefore it would seem wise, if a decision is taken to operate, not to make any promises to the patients about improvement of function insofar as aphagia is due to paralysis of the constrictors. Diagnosis, it should be remembered, can only be made after electromanometric investigation which is an essential preliminary to any therapeutic decision.