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Cricopharyngeal achalasia treated with myectomy and post-operative high-resolution manometry

Toshihiko Watanabe1, Takahiro Shimizu1, Masataka Takahashi1

  • 1Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan.

International Journal of Pediatric Otorhinolaryngology
|May 22, 2014
PubMed

Insights

Cricopharyngeal achalasia, a rare cause of pediatric dysphagia, was successfully treated with cricopharyngeal myectomy. This surgery resolved symptoms, enabling normal eating and preventing further complications.

Area of Science:

  • Pediatric Gastroenterology
  • Otolaryngology
  • Surgical Innovation

Background:

  • Cricopharyngeal achalasia is an uncommon etiology of dysphagia in pediatric populations.
  • Symptoms include feeding difficulties, recurrent pulmonary infections, and growth stunting.

Observation:

  • A nine-year-old female presented with a prolonged history of dysphagia, recurrent pulmonary infections, and growth stunting.
  • Initial management involved gastrostomy for nutritional support and pharyngeal inflammation reduction.

Findings:

  • Cervical cricopharyngeal myectomy was performed, leading to prompt symptom resolution without complications.
  • Post-operative high-resolution manometry showed reduced upper esophageal pressure and normal relaxation during swallowing.
  • The patient achieved normal oral intake of solids and liquids, remaining asymptomatic at six months.

Implications:

  • Cricopharyngeal myectomy is an effective surgical treatment for pediatric cricopharyngeal achalasia.
  • This intervention can significantly improve quality of life by restoring normal swallowing function.
  • Early surgical management may prevent long-term complications associated with chronic dysphagia.

Keywords:
Cricopharyngeal achalasiaCricopharyngeal myectomyDysphagiaHigh-resolution manometryMotilityPharyngocele

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