What Is a Cricopharyngeal Myotomy?

A cricopharyngeal myotomy is a surgery performed to cut through one of the muscles in the esophagus to help a patient swallow. It takes around an hour to complete when the procedure goes smoothly and patients may be able to go home the same day, depending on how quickly they recover. This treatment option may be considered if more conservative approaches to the patient’s swallowing condition are not effective. Patients should be able to eat and drink more comfortably after the surgery.

In some patients with dysphagia, a condition where they have difficulty swallowing, the cricopharyngeus muscle is involved. It can spasm, making it hard to pass boluses of food. Sectioning the muscle can permit the esophagus to work more smoothly, allowing food to pass freely to the stomach, and can reduce discomfort for the patient.

When someone presents with dysphagia, a number of medical evaluations can be performed to determine the cause and develop a treatment plan. These can include swallowing studies with medical imaging equipment, tests to check for causes like tumors or gastroesophageal reflux disease, and a physical examination. Testing is important, because it may influence the most appropriate course of treatment; if the cause is a tumor, for example, the patient needs surgery, chemotherapy, or radiation to resolve the issue.

The result of testing may indicate that the cricopharyngeus muscle could be involved. Conservative treatments like sessions with a speech-language pathologist may be recommended first to see if the problem can be addressed without surgery. If these efforts fail, a doctor may recommend a cricopharyngeal myotomy. Before the surgery, the patient is evaluated for any risk factors and contraindications, and receives advice on eating, drinking, and taking medications in advance of the procedure.

At the hospital, the patient is anesthetized so the doctor can make a small incision in the throat to access the cricopharyngeus muscle and section it. It is possible to perform a cricopharyngeal myotomy endoscopically, with a minimum of damage to the patient, although it can take slightly more time. Once the procedure is finished, the patient is taken to recovery for monitoring. If people are drinking well and breathing comfortably, with their pain well-controlled, they can be discharged to recover at home.

Recovery from a cricopharyngeal myotomy includes several days of rest with soft foods that will be easy to swallow. The patient should be careful to keep the surgical site clean and dry, and must take antibiotic medications to prevent infection. Pain management is also available to ease discomfort after a cricopharyngeal myotomy. Staying alert to signs of infection like pain, swelling, and redness around the site is important so the patient can be treated promptly for complications.