Dimension of the pharyngo-esophageal segment in dysfunction of the cricopharyngeal muscle

Defective relaxation of the cricopharyngeal muscle (cricopharyngeal dysfunction) is radiographically demonstrated as a posterior impression into the pharyngo-esophageal segment of the gullet in patients with dysphagia. It has been assumed that this impression implies a mechanical obstacle to the swallowed bolus. Therefore, the width of the pharyngo-esophageal segment was measured in three groups of individuals; 139 non-dysphagic volunteers, 25 dysphagic patients with a normal relaxation of the cricopharyngeus and 25 dysphagic patients with cricopharyngeal dysfunction. Compared with the other two groups of patients studied the patients with cricopharyngeal dysfunction were found to have a slightly wider gullet above and below the cricopharyngeal muscle. However, at the level of the cricopharyngeal muscle they had an equal sized or slightly narrower lumen than the patients in the two control groups. The results obtained suggest that the posterior impression due to cricopharyngeal dysfunction does not cause a substantial mechanical obstacle to swallowing in the majority of patients.