Partial Cricopharyngeal Myotomy for Treatment of RetrogradeCricopharyngeal Dysfunction

摘要

Retrograde cricopharyngeal dysfunction (R-CPD) is a recently described debilitatingsyndrome resulting from an inability of the cricopharyngeus muscle to relax forretrograde release of excess swallowed air. This results in the daily experience of the 4 cardinal symptoms of inability tobelch; loud and therefore socially awkward gurgling noises; daily discomfort in lowneck, chest, and abdomen; and excessive flatulence. Less universal symptoms includepostprandial painful hiccups, nausea, hypersalivation in response to the need to belch,and even shortness of breath with exertion due to inability to inhale fully due toesophageal/abdominal air, especially when the latter causes abdominal distention.Importantly, patients with this condition report significant social inhibition with asubstantial quality of life impact. Due to their distress from the condition, manypatients see several physicians and undergo various procedures, including esophagoscopy,barium studies, and esophageal manometry. None of these tests to date have provided adiagnosis in a caseload numbering 255, and instead, diagnosis is based on thesyndrome.