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Dysphagia associated with cricopharyngeal dysfunction.

A R Schultz, P Niemtzow, S R Jacobs

    Archives of Physical Medicine and Rehabilitation
    |August 1, 1979
    PubMed
    Summary
    This summary is machine-generated.

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    Dysphagia management for neuromuscular dysfunction can be improved with speech therapy. Conservative treatments, including dietary modifications and swallowing exercises, helped patients avoid cricopharyngeal myotomy.

    Area of Science:

    • Neurology
    • Gastroenterology
    • Speech Pathology

    Background:

    • Protracted dysphagia from neuromuscular dysfunction often leads to considering upper esophageal sphincter myotomy.
    • Indications and outcomes for cricopharyngeal myotomy remain unclear in medical literature.

    Observation:

    • Three cases of dysphagia due to cricopharyngeal sphincter dysfunction post-neurological events (brain stem infarctions, inflammatory disease) were analyzed.
    • Barium swallow revealed aspiration and cricopharyngeal sphincter non-relaxation; indirect laryngoscopy showed vocal cord paralysis.
    • Speech pathology evaluation found no oral musculature abnormalities, and one patient had normal laryngeal EMG.

    Findings:

    • All patients initially required gastrostomies for nutritional support due to severe dysphagia and aspiration.

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  • Targeted therapeutic modifications, including food consistency, rate, quantity, and aspiration prevention counseling, were implemented.
  • Successful oral feeding without aspiration was achieved in all three patients within the treatment period.

    • Implications:

    • Conservative management, including speech therapy and dietary adjustments, can be effective in treating dysphagia associated with cricopharyngeal dysfunction.
    • Cricopharyngeal myotomy may not be necessary for all patients with long-standing swallowing difficulties, even with apparent neuromuscular deficits.
    • This study highlights the potential for non-surgical interventions to restore safe oral feeding and obviate the need for surgical procedures.