Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Jan 10;18(2):10.
doi: 10.3892/mco.2023.2606. eCollection 2023 Feb.

New, safe and simple endoscopic cricopharyngeal myotomy with a curved rigid laryngoscope: A case report

Takashi Maruo  1 , Yasushi Fujimoto  1 , Sayaka Yokoi  2 , Mayu Shigeyama  2 , Naoki Nishio  2 , Mariko Hiramatsu  2 , Michihiko Sone  2
Affiliations
Case Reports

New, safe and simple endoscopic cricopharyngeal myotomy with a curved rigid laryngoscope: A case report

Takashi Maruo et al. Mol Clin Oncol. .

Abstract

Endoscopic cricopharyngeal myotomy (ECPM) is a safe and minimally invasive technique that is used to treat patients whose esophageal inlet fails to open because of specific diseases, such as Wallenberg's syndrome and neuromuscular diseases. The present study described the performance of a new, safe and simple ECPM using a curved rigid laryngoscope, which is used for endoscopic laryngopharyngeal surgery for patients with dysphagia due to pharyngeal residue after swallowing. The patient was an 80-year-old woman with laryngeal palsy caused by lower cranial nerve palsy after cranial base schwannoma surgery. ECPM was performed with a curved rigid laryngoscope. The postoperative course was good; postoperative rehabilitation eliminated the residue after swallowing a thickened solution and mealtimes were shorter than before surgery. This procedure allows the hypopharynx to be widely expanded and it is possible to develop a wider surgical field than when using a direct laryngoscope. In addition, this procedure appears to be relatively easy to perform if the surgeon is familiar with the curved rigid laryngoscope technique.

Keywords: ECPM; cricopharyngeal myotomy; dysfunction of the esophageal inlet; dysphagia; upper esophageal sphincter myotomy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
The difference in the surgical field between the (A) direct laryngoscope and the (B) curved rigid laryngoscope.
Figure 2
Figure 2
Surgical instruments. (A) Curved rigid laryngoscope. (B) Surgical instruments, from left to right: suction (long, short), grasping forceps (2 curved, 1 straight), curved-tip monopolar, bipolar scissors, suction coagulator.
Figure 3
Figure 3
Surgical set-up. Laryngeal expansion with a curved rigid laryngoscope.
Figure 4
Figure 4
Intraoperative photographs. (A) The field of view for identifying the cricopharyngeal muscle. The arrow in the figure indicates the cricopharyngeal muscle as a submucosal ridge on the posterior wall of the esophageal inlet. (B) Mucosal incision. (C) Detachment of the cricopharyngeal muscle from the surrounding tissue. The arrow in the figure indicates the cricopharyngeal muscle. (D) Cutting of the cricopharyngeal muscle. (E) Buccopharyngeal fascia visible after cutting the cricopharyngeal muscle. The arrow in the figure indicates the buccopharyngeal fascia. (F) Wound protection with a polyglycolic acid sheet after resection.
Figure 5
Figure 5
Videofluorographic findings. (A) Preoperative findings. Residue after swallowing. (B) Postoperative findings. Smooth passage with no accumulation using head rotation position swallowing.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Halvorson DJ, Kuhn FA. Transmucosal cricopharyngeal myotomy with the potassium-titanyl-phosphate laser in the treatment of cricopharyngeal dysmotility. Ann Otol Rhinol Laryngol. 1994;103:173–177. doi: 10.1177/000348949410300302. - DOI - PubMed
    1. Pitman M, Weissbrod P. Endoscopic CO2 laser cricopharyngeal myotomy. Laryngoscope. 2009;119:45–53. doi: 10.1002/lary.20032. - DOI - PubMed
    1. Chitose S, Sato K, Hamakawa S, Umeno H, Nakashima T. A new paradigm of endoscopic cricopharyngeal myotomy with CO2 laser. Laryngoscope. 2011;121:567–570. doi: 10.1002/lary.21362. - DOI - PubMed
    1. Satou Y, Omori T, Tagawa M. Treatment of superficial carcinoma in the hypopharynx. Nihon Jibiinkoka Gakkai Kaiho. 2006;109:581–586. doi: 10.3950/jibiinkoka.109.581. (In Japanese) - DOI - PubMed
    1. Bunch PM, Hughes RT, White EP, Sachs JR, Frizzell BA, Lack CM. The pharyngolaryngeal venous plexus: A potential pitfall in surveillance imaging of the neck. AJNR Am J Neuroradiol. 2021;42:938–944. doi: 10.3174/ajnr.A7033. - DOI - PMC - PubMed

Publication types