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Pitfalls and complications of cricopharyngeal myotomy
D Brouillette1, E Martel, L Q Chen
1Department of Surgery, Université de Montréal Medical Center, Quebec, Canada.
Abstract:
Despite a meticulous operative technique, complications still may occur following cricopharyngeal myotomy. In our series of 205 patients, infection was seen in 11 patients (5.3%) with fistula formation for two patients (1.0%). These complications were seen more frequently in patients treated for a pharyngoesophageal diverticulum. Mortality directly related to the surgical procedure was seen in three patients (1.4%), all suffering from muscular dystrophy.
Insights
Cricopharyngeal myotomy can lead to complications like infection and fistula, particularly in patients with pharyngoesophageal diverticulum. Mortality was low, affecting only muscular dystrophy patients.
Area of Science:
- Otolaryngology
- Surgical Pathology
Background:
- Cricopharyngeal myotomy is a surgical procedure to treat cricopharyngeal muscle dysfunction.
- Complications can arise despite careful surgical technique.
Purpose of the Study:
- To analyze the incidence and types of complications following cricopharyngeal myotomy.
- To identify patient factors associated with increased complication rates.
Main Methods:
- Retrospective review of 205 patients undergoing cricopharyngeal myotomy.
- Analysis of complication rates, including infection, fistula, and mortality.
Main Results:
- Overall complication rate was 5.3% for infection and 1.0% for fistula.
- Complications were more frequent in patients with pharyngoesophageal diverticulum.
- Mortality occurred in 1.4% of patients, exclusively in those with muscular dystrophy.
Conclusions:
- Cricopharyngeal myotomy is associated with a low but notable risk of complications.
- Pharyngoesophageal diverticulum is a risk factor for post-myotomy complications.
- Patients with muscular dystrophy face a higher mortality risk after this procedure.