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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2012 October;171(5):669-73

language: English

Myotomy of cricopharyngeal muscle in the therapy of dyskinesia of upper esophageal sphincter

Cremona F., Maiorana A., Agnello G.

Department of General Surgery and Metabolic Diseases, Paolo Giaccone General Hospital, Palermo, Italy


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Dyskinesia of the esophagus includes the entire esophagus from the upper esophageal sphincter to the lower esophageal sphincter together with a wide spectrum of physiopathological and clinical variations. Related to functional diseases such as Dyskinesia of UES (Upper Esophageal Sphincter), myotomy 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 intervention 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.

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