Abstract
“Cricopharyngeal achalasia” appears to be defined as a failure of the cricopharyngeal muscle to relax or as its premature contraction during the pharyngeal stage of deglutition. Our electromyographic, radiographic and histological investigations led to the conclusion that there are NO such conditions. In the conditions where “cricopharyngeal achalasia” has been thought to exist in association with other neuromuscular diseases, the cricopharyngeal muscle does relax in normal timing. However, since the propelling force is lessened because of weakness of the lingual and/or pharyngeal muscles, bolus does not enter the esophagus during the cricopharyngeal relaxation. Therefore, it is not the cricopharyngeal muscle but the tongue and/or pharyngeal muscles that is responsible for dysphagia. In the conditions where “cricopharyngeal achalasia” appears to be the only problem, again the cricopharyngeal muscle does relax. This was confirmed electromyographically in 5 patients. Results of a histological study suggest that the genesis of dysphagia in these conditions is a decrease in expansibility of the cricopharyngeal muscle resulting from a myopathy. We propose that these conditions should be called “idiopathic cricopharyngeal myopathy.”
