Myotomy of cricopharungeal muscle in the therapy of dyskinesia of upper esophageal sphincter: personal experience

Dyskinesia of the esophagus includes the entire esophagus from the upper esophageal sphincter to the lower esophageal sphinc - ter together with a wide spectrum of physi - opathological and clinical variations. Related to functional diseases such as Dyskinesia of UES (Upper Esophageal Sphincter), myo- tomy is an excellent procedure for patients with cervical dysphagia. In our experience, the surgical treatment is the only procedure to treat UES dyskinesia. For a successful in - tervention is mandatory: a pharyngeal pump efficiency, hypertension of UES and conservation of esophageal peristalsis in the absence of GERD (Gatroesophageal Reflux Disease). From January 2006 to December 2011, the Authors have treated 11 patients, 9 of which suffered from idiopathic Dyskinesia of UES, 2 had a previous brain ictus; 4 of them had an associated Zenker diverticulum; in 1 case there was an associated goiter. In all these cases we have performed an extramucosal myotomy of cricopharyngeal muscle through a right laterocervical approach. All the patients had benefit from the operation immediately, with resolution of dysphagia, one patient with previous brain ictus, has enjoyed only a partial improvement of symptoms, in one case we performed contemporary a thyroidectomy. The authors believe in the surgical treatment as the only procedure, after accurate selection of patients, to the cure of the patients.