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• W2977747078 abstract "Introduction: The mechanism of swallowing is a complex series of events involving coordinated participation of the oral cavity, oropharynx, larynx, and esophagus. The upper esophageal sphincter (UES), a 2-5cm area extending from the distal pharynx to proximal esophagus, regulates entrance of the food bolus into the esophagus. The cricopharyngeal muscle (CP) is situated between the inferior constrictor and cervical esophagus and has a major contribution to the action of the UES. Hyperfunction of the CP can result from a number of local or systemic disease states and can lead to progressive dysphagia. Methods: After IRB approval, we performed a retrospective review of patients undergoing endoscopic cricopharyngeal myotomy. Patients were identified by accessing the senior authors' surgical databases from January 2011 - March 2015. Demographic data, diagnosis, preoperative symptomatic status, preoperative manometry data, type of laser used, type of mucosal closure, operative time, data on hospital course, complications, and postoperative status were all documented. Results: We identified 43 patients who underwent endoscopic laser cricopharyngeal myotomy (CPM) with mucosal closure. The primary diagnosis for each patient was dysphagia secondary to cricopharyngeal hyperfunction. The mean preoperative UES pressure was 201mmHg (30-118 normal range) with a standard deviation of 47.5. The majority of procedures were performed with the Diode fiber laser and mucosal closure accomplished with barbed knotless suture. The average case length was 99.8 minutes. The average hospital stay was 2.1 days with an average time to PO of 0.34 days postoperatively. We had a 4.6% complication rate consisting of one esophageal perforation resulting in deep neck abscess and one hypopharyngeal mucosal tear. We also found that 98% of patients had either improved symptoms or no residual dysphagia when compared to their preoperative status with a 9.7 month average follow-up. Conclusion: The standard of definitive therapy for cricopharyngeal hyperfunction is surgical myotomy. Endoscopic CPM is an effective therapy which alleviates the need for an incision in the neck and provides good outcomes with short hospital stays and low complication rates. A number of methods can be used to perform the myotomy. We describe the first series of patients in which a Diode fiber laser is used accompanied by primary mucosal closure.Figure 1Figure 2Figure 3" @default.
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• W2977747078 date "2015-10-01" @default.
• W2977747078 modified "2023-09-27" @default.
• W2977747078 title "Outcomes After Endoscopic Cricopharyngeal Myotomy Using a Diode Laser and Mucosal Closure" @default.
• W2977747078 doi "https://doi.org/10.14309/00000434-201510001-01637" @default.
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