Abstract
Inclusion body myositis（IBM）is a chronic inflammatory myopathy that predominantly affects individuals over the age of 50, often presenting with impaired opening of the esophageal inlet.
We report the case of an 82-year-old woman who had been diagnosed with IBM by a neurologist four years earlier and was referred to our department for evaluation of surgical options to improve her swallowing function. She had experienced dysphagia for two and a half years, initially managed with balloon dilation. However, the effectiveness of this treatment gradually declined, resulting in worsening sore throat and difficulty swallowing.Given the IBM-related obstruction at the esophageal inlet, the patientʼs preference to avoid a cervical incision, and concerns about surgical invasiveness at her advanced age, we elected to perform endoscopic cricopharyngeal myotomy（ECPM）.
Postoperatively, her recovery was uneventful, and she resumed oral intake by postoperative day 7. The procedure eliminated the need for further balloon dilations, and her Food Intake Level Scale（FILS）score improved from Level 8 to Level 9.
This case highlights ECPM as a safe and effective minimally invasive option for managing dysphagia in elderly patients with IBM.
