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Cricopharyngeal dysfunction with significant piriform sinus expansion: case report.
S Chitose1, H Umeno, S Hamakawa
1Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan. yonekawa@med.kurume-u.ac.jp
The Journal of Laryngology and Otology. Supplement
|May 23, 2009
Summary
Cricopharyngeal dysfunction in an 80-year-old man caused significant piriform sinus expansion and dysphagia. A subsequent cricopharyngeal myotomy successfully resolved his swallowing difficulties.
Area of Science:
- Otolaryngology
- Gastroenterology
- Neurology
Background:
- Cricopharyngeal dysfunction can lead to significant swallowing difficulties.
- Piriform sinus expansion is an uncommon sequela of cricopharyngeal dysfunction.
Observation:
- An 80-year-old male presented with a 3-year history of dysphagia.
- Electromyography revealed cricopharyngeal chalasis (dysfunction) with associated piriform sinus expansion.
- Initial bougie widening provided minimal relief.
Findings:
- Cricopharyngeal myotomy, performed after a 6-month recovery period, completely resolved the patient's dysphagia.
- Histopathological findings suggested cricopharyngeal myopathy as the underlying cause.
Implications:
- Cricopharyngeal myotomy is an effective treatment for dysphagia secondary to cricopharyngeal dysfunction and associated piriform sinus expansion.
- This case highlights the importance of considering cricopharyngeal myopathy in patients with unexplained dysphagia and piriform sinus abnormalities.
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