[Myotomy of the upper esophageal sphincter in upper functional dysphagia. A series of 34 cases]

Patients with disorders of the upper oesophagus often present with swallowing impairment. We evaluated our results in 34 patients treated with cricopharyngeal myotomy.

Etiologies were muscular in 11 patients, neurogenic in 10, cricopharyngeal achalasia in 7 and could not be ascertained in 6. A 4 to 6 cm myotomy of the cricopharyngeal muscle and the lower part of the oesophageal constrictor muscle was performed. Incision was made to the mucosa. Outcome was evaluated in terms of functional improvement, weight gain and post-operative mode of food intake.

Favourable results were obtained in 19 patients. Incomplete improvement was achieved in 6 and the operation was unsuccessful in 11.

The quality of residual pharyngeal propulsion appears to be the determining element in operative success and should be used in determining indications.