Cricopharyngeal Myotomy (CPM)
A procedure in which the cricopharyngeus muscle, which makes a “ring” around the upper esophagus, is divided or cut across in order to break its grip. A cricopharyngeal myotomy is done in cases where this cricopharyngeus muscle (i.e., the upper esophageal sphincter) fails to relax when one swallows (cricopharyngeal dysfunction), resulting in a functional obstruction.
Cricopharyngeal dysfunction can be seen alone, or, as illustrated below, in combination with a Zenker’s diverticulum. Symptoms of cricopharyngeal dysfunction include dysphagia, with solids more so than with liquids. If a Zenker’s diverticulum is present, the patient may also experience late “regurgitation” of undigested food retained for hours or longer in the sac.
Cricopharyngeal Dysfunction, before and after Myotomy
Cricopharyngeus Myotomy for Recreational Eating and Management of Saliva
98 year-old before and after Myotomy
Great View of Fresh Cricopharyngeus Myotomy Surgical Wound
Bolus Stream before and after Cricopharyngeus Myotomy
VESS (videoendoscopic swallow study) Findings after Radiotherapy
The Evolution of a Cricopharyngeus Myotomy Wound
Zenker’s Diverticulum a Week after Cricopharyngeus Myotomy
Swallowing Trouble 101
This video gives an overview of how swallowing works, how it can sometimes go wrong (presbyphagia or cricopharyngeal dysfunction), and possible ways to treat those problems (swallowing therapy or cricopharyngeal myotomy).