Cricopharyngeal dysfunction (CPD)

Failure of the tonically contracted upper esophageal sphincter to relax and open when one swallows. Cricopharyngeal dysfunction is also known as cricopharyngeal achalasia. The cause is usually unknown.

The upper esophageal sphincter is also known as the cricopharyngeus muscle and is located at the lower level of the voicebox or larynx. This muscle is always contracted except at the moment of swallowing, when it relaxes briefly to let food or liquid pass through.

Symptoms and treatment for cricopharyngeal dysfunction:

Typically, individuals with cricopharyngeal dysfunction first notice that pills or solid food begin to lodge at the level of the lower part of the larynx. The problem tends to progress inexorably, though often slowly, as the years pass, until the individual must limit himself or herself to liquid and soft foods. Cricopharyngeal dysfunction is fully resolved through a straightforward surgical procedure (cricopharyngeal myotomy), performed through the mouth with the laser or, only occasionally, through a neck incision. See also: Zenker’s diverticulum.


Photos:


Videos:

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Cricopharyngeal Dysfunction: Difficulty Swallowing, Especially Solid Foods
Dr. Bastian explains this progressive swallowing problem and presents options for treatment.
Cricopharyngeal Dysfunction: Before and After Cricopharyngeal Myotomy
This video shows x-rays of barium passing through the throat, first with a narrowed area caused by a non-relaxing upper esophageal sphincter (cricopharyngeus muscle), and then after laser division of this muscle. Preoperatively, food and pills were getting stuck at the level of the mid-neck, and the person was eating mostly soft foods. After the myotomy (division of the muscle), the patient could again swallow meat, pizza, pills, etc. without difficulty.