Abstract
Cricopharyngeal dysfunction is defined as the delayed or incomplete relaxation of the cricopharyngeal muscle during swallowing. This may cause dysphagia and aspiration, affecting the quality of life. For this condition, injection of botulinum toxin into the cricopharyngeus, dilatation of cricopharynx with bougies and external cricopharyngeal myotomy have been the treatment of choice with varying results. We present in this paper the treatment of this clinical condition by KTP 532 laser a recent advance in the field of Otolaryngology and Head and Neck Surgery. Very few series have been reported in literature so far regarding the use of laser for cricopharyngeal myotomy. This is perhaps the first series of eight cases of KTP laser assisted microendoscopic cricopharyngeal myotomy and web excision reporting the benefit of this treatment by an Indian author in an Indian Journal. KTP laser assisted cricopharyngeal myotomy avoids an external scar; aids precise incision at the cricopharynx by direct visualization, brings optimum results in deglutition and reduces postoperative morbidity and complications. The short hospital stay reduces the overall cost. The use of KTP 532 laser in the treatment of selected cases with cricopharyngeal dysfunction is therefore safe and effective.
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References
□ Ellis HF, Gibb PS, Williamson WA. Current status of cricopharyngeal myotomy for cervical esophageal dysphagia. Eur J Cardio Thoracic Surg 1996;10:1033–9.
□ McKenna JA, Dedo IIII. Cricopharyngeal myotomy. Indications and technique. Ann Otol Rhinol Laryngol 1992;101:216–21.
□ Ekberg O, Nylander G. Dysfunction fo the cricopharyngeal muscle. A cineradiographic study of patients with dysphagia. Radiology 1982;143:481–6.
□ Aviv JE, Kim T, Thomson JE, Sunshine S, Kaplan S, Close LG. Fibreoptic endoscopic evaluation swallowing with sensory testing (FEESST) in healthy controls. Dysphagia 1998;13:87–92.
□ Blitzer A, Brin MF. Use of botulinum toxin for diagnosis and management of cricopharyngeal achalasia. Otolaryngol Head and Surgery 1997;116:329–30.
□ Berg HM, Jacobs JB, Persky MS, Cohen NL. Cricopharyngeal myotomy: A review of surgical results in patients with cricopharyngeal achalasia of neurogenic origin. Laryngoscope 1985;95:1337–40.
□ St. Guily JL, Perie S, Thiebaut NW. Swallowing disorders in muscular diseases: Functional assessment and indications of cricopharyngeal myotomy. ENT J 1994;73:34–40.
□ St. Guily JL, Zhang K, Perie S. Improvement of dysphagia following cricopharyngal myotomy in a group of elderly patients. Histochemical and biochemical assessment of the cricopharyngeal muscle. Am Otol Rhinol Laryngol 1995;104:603–9.
□ Bastian RW, Muzaffar K. Endoscopic laser cricopharyngeal myotomy to salvage tracheoesophageal voice after total laryngectomy. Arch Otolaryngol Head Neck Surg 2001;127:691–3.
□ Halverson. The treatment of cricopharyngeal dysmotility with a transmucosal cricopharyngeal myotomy using the potassium-titanyl-phosphate (KTT) laser. Endoscopy 1998;30:46–50.
□ Brondbo K. Treatment of cricopharyngeal dysfunction by endoscoic laser myotomy. Acta Otolaryngol 2000;543:222–4.
□ Pera M, Yamada A, Hiebert CA, Durancean A. Sleeve recording of upper esophageal sphincter resting pressures during cricopharyngeal myotomy. Ann Surg 1997;225:229–34.
□ Pera M, Yamada A, Hiebert CA, Duranceau A. Sleeve recording of the upper esophageal resting pressures during cricopharyngeal myotomy. Ann Surg 1997;225:229–34.
□ Zaäsen, Schär, Tschopp L, Becker M, Häusler R. Surgical treatment of Zenker's diverticulum transcutaneous diverticulectomy versus microendoscopic myotomy of the crieopharyngeal muscle with CO2 laser. Otolaryngol Head Neck Surg 1999;121:482–7.
□ Brouillette D, Martel E, Chen L, Duranceau A. Pitfalls and complications of cricopharyngeal myotomy. Chest Surg Clin North Am 1997;7:457–73.
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Hazarika, P., Parul, P., Kailesh, P. et al. KTP Laser assisted microendoscopic cricopharyngeal myotomy and web excision for dysphagia management. Indian J Otolaryngol Head Neck Surg 57, 290–293 (2005). https://doi.org/10.1007/BF02907689
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DOI: https://doi.org/10.1007/BF02907689