What is the role of cricopharyngeal myotomy (CPM) in the treatment of dysphagia?

Updated: Mar 20, 2020
  • Author: Nam-Jong Paik, MD, PhD; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Answer

Cricopharyngeal myotomy (CPM) is a procedure designed to decrease pressure on the pharyngoesophageal sphincter (PES) by incising the main muscular component of the PES. However, no means of precisely determining the underlying PES dysfunction exists. For this reason, no rational guidelines have been compiled for recommending CPM.

Even less certain is the advisability of performing a CPM in patients with neurogenic dysphagia, such as patients with stroke. The fact that neurogenic causes of dysphagia usually involve a lack of coordination of the swallow rather than any intrinsic or extrinsic muscle dysfunction probably explains this consideration. The injection of botulinum toxin injection into the PES has been introduced as a replacement for CPM.


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