Feeding difficulties in a neonate with primary cricopharyngeal achalasia treated by cricopharyngeal myotomy

Abstract

Primary cricopharyngeal achalasia resulting from failure of relaxation of the cricopharyngeus muscle is a rare but significant cause of dysphagia in newborns. Symptoms may be nonspecific. Although surgical management with cricopharyngeal myotomy has been employed successfully for the treatment of this disorder, swallowing difficulties may persist postoperatively, probably due to association with other esophageal abnormalities. Alternative methods of feeding may be required to ensure adequate nutrient intake. We report the case of a full-term, 2-day-old neonate with this rare clinical condition, treated by myotomy, in whom swallowing difficulties persisted for several weeks after surgery. Satisfactory nutrition was maintained postoperatively with the support of a nasogastric feeding tube until improvement in feeding intolerance. Complete symptomatic relief was attained at the age of 5 months.