Dominic Stone
The cricopharyngeal muscle is a muscular constrictor located in the inferior constrictor that acts as the upper oesophageal sphincter. Its primary function is to keep the oesophageal inlet closed, except during swallowing. The cricopharyngeal muscle relaxes and opens when food approaches, allowing food to pass from the pharynx into the oesophagus. Cricopharyngeal dysfunction can cause dysphagia, which is difficulty swallowing, and can be treated with a cricopharyngeal myotomy, botulinum toxin injections, or balloon dilation.
| Characteristics | Values |
|---|---|
| Location | Inferior constrictor |
| Function | Keeps the oesophageal inlet closed, except during swallowing |
| Type | Striated muscle |
| Innervation | Branches of the vagus nerves and recurrent laryngeal nerve |
| Dysfunction | Cricopharyngeus muscle dysfunction (CPD) |
| Diagnosis | Visual examination, esophageal manometry, modified barium swallow study (MBS), videofluoroscopic swallow study (VFSS), flexible endoscopic evaluation of swallowing |
| Treatment | Cricopharyngeus myotomy, botulinum toxin injection, balloon dilation, respiratory muscle strength training, surgery |
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What You'll Learn
- The cricopharyngeal muscle is a component of the upper oesophageal sphincter
- It relaxes and opens when food approaches, allowing food to pass from the pharynx into the oesophagus
- Cricopharyngeal dysfunction can be diagnosed in several ways, including visual examination and esophageal manometry
- Treatment for cricopharyngeal dysfunction includes cricopharyngeal myotomy, botulinum toxin injection, and balloon dilation
- The muscle is located in the inferior constrictor
The cricopharyngeal muscle is a component of the upper oesophageal sphincter
The cricopharyngeal muscle is also referred to as the cricopharyngeus muscle. It is the main component of the closure muscles of the esophageal introitus or upper oesophageal sphincter muscles, which also include the inferior pharyngeal constrictor and the cervical oesophagus. The length of the EI is about 3 cm to 5 cm. The cricopharyngeal muscle is responsible for the high-pressure zone within the EI.
Cricopharyngeal dysfunction (CPD) occurs when the muscle fails to relax or expand in a coordinated manner. CPD can be caused by a variety of conditions and can manifest as asymptomatic or profound dysphagia. A person with dysphagia may experience coughing or choking when eating or drinking, a gurgly-sounding voice, drooling, food or liquid spilling from the mouth, and other symptoms. Diagnosis of CPD can be accomplished through a combination of clinical and instrumental swallowing evaluations, including flexible endoscopic evaluation of swallowing, videofluoroscopic swallow studies, and high-resolution manometry.
Treatment for cricopharyngeal dysfunction includes nonsurgical interventions such as pharyngoesophageal segment dilation, botulinum toxin injection, and cricopharyngeal myotomy. Cricopharyngeal myotomy involves cutting the muscle to prevent it from over-tightening and blocking food from entering the oesophagus. Balloon dilation is another minimally invasive procedure used to stretch the muscle and allow food and liquid to pass through more easily. Respiratory muscle strength training can also be used to improve coughing productivity and prevent food or liquid from entering the lungs.
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It relaxes and opens when food approaches, allowing food to pass from the pharynx into the oesophagus
The cricopharyngeus muscle is an important component of the inferior constrictor and acts as an upper oesophageal sphincter. It is located in the inferior constrictor and is supplied by the recurrent and external laryngeal nerves. Its primary function is to keep the oesophageal inlet closed, except during swallowing.
When food approaches, the cricopharyngeus muscle relaxes and opens, allowing food to pass from the pharynx into the oesophagus. This process is known as swallowing. The cricopharyngeus muscle is one component of the upper oesophageal sphincter, and the failure of its coordinated relaxation or expansion is termed cricopharyngeus muscle dysfunction (CPD). CPD can cause dysphagia, or difficulty swallowing, and can range from asymptomatic to profound dysphagia.
A person with CPD may experience coughing or choking when eating or drinking, a wet or gurgly sounding voice, drooling, food or liquid spilling from the mouth, pocketing or holding contents in the mouth, food getting stuck in the throat, and lengthy meal times. CPD can be diagnosed through a combination of clinical and instrumental swallowing evaluations, including flexible endoscopic evaluation of swallowing, video-fluoroscopic swallow study, and high-resolution manometry.
Treatment options for CPD include nonsurgical interventions such as pharyngoesophageal segment dilation, botulinum toxin injection, and cricopharyngeus myotomy. Cricopharyngeus myotomy involves cutting the upper oesophageal sphincter to prevent it from over-tightening and blocking food from entering the oesophagus. This procedure can be performed through an incision in the neck or endoscopically through the mouth. Endoscopic cricopharyngeal myotomy is a minimally invasive procedure that offers faster recovery and may be safer than traditional surgery.
In summary, the cricopharyngeus muscle plays a crucial role in the swallowing process by relaxing and opening when food approaches, allowing food to pass from the pharynx into the oesophagus. Dysfunction of this muscle can lead to swallowing difficulties, but various treatment options are available to improve symptoms and restore normal swallowing function.
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Cricopharyngeal dysfunction can be diagnosed in several ways, including visual examination and esophageal manometry
The cricopharyngeal muscle, also known as the cricopharyngeus, is a muscle located in the inferior constrictor that serves as the primary component of the upper oesophageal sphincter (UES). The UES is a valve at the top of the oesophagus, or food pipe, which is the tube that connects the throat to the stomach. The cricopharyngeal muscle is usually closed until a person swallows. Its primary function is to keep the oesophageal inlet closed, except during swallowing, and to prevent food from entering the airway.
Cricopharyngeal dysfunction occurs when the cricopharyngeal muscle doesn't relax or relaxes in an uncoordinated manner, blocking food from entering the oesophagus and making swallowing difficult or painful. This can lead to people with the condition limiting their diet to soft foods, and in some cases, drastically changing their diet, resulting in weight loss. It is most common in older adults.
Cricopharyngeal dysfunction can be diagnosed in several ways, including visual examination and oesophageal manometry. A visual examination can be done using a flexible endoscope, which is inserted through the mouth to examine the oesophageal inlet and hypopharynx. This allows doctors to observe the cricopharyngeal muscle in both its relaxed and contracted states.
Oesophageal manometry is another diagnostic tool that measures muscle contractions when a person swallows, showing the coordination of muscles during this process. This procedure can help determine whether the muscles that move food down the oesophagus and prevent reflux are functioning properly.
In addition to visual examination and oesophageal manometry, other diagnostic methods include an X-ray swallow test, also known as a modified barium swallow, and a videofluoroscopic swallow study. The former involves swallowing a small amount of barium mixed with water or oil, which coats the oesophagus and makes it more visible on an X-ray. The latter uses video fluoroscopy to evaluate swallowing function and can be combined with manometry for a more comprehensive assessment.
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Treatment for cricopharyngeal dysfunction includes cricopharyngeal myotomy, botulinum toxin injection, and balloon dilation
The cricopharyngeal muscle, also known as the cricopharyngeus muscle, is an important component of the inferior constrictor and acts as an upper oesophageal sphincter. It is responsible for keeping the oesophageal inlet closed, except during swallowing. When food is swallowed, the muscle relaxes to allow food to pass through to the oesophagus.
Cricopharyngeal dysfunction occurs when the muscle fails to relax or expand, leading to dysphagia and obstruction of the food passage. This can cause severe dysphagia and aspiration, and can even lead to malnutrition, impaired quality of life or death. Treatment for cricopharyngeal dysfunction includes cricopharyngeal myotomy, botulinum toxin injection, and balloon dilation.
Cricopharyngeal myotomy is a surgical method that involves making an incision in the cricopharyngeal muscle to relieve the obstruction. It is considered the optimal choice for primary cricopharyngeal achalasia, but its effectiveness is thought to be unsatisfactory. Cricopharyngeal myotomy is also not suitable for patients in poor medical condition.
Botulinum toxin injection, also known as Botox, is another treatment option. It involves injecting the toxin into the cricopharyngeal muscle to relax it and improve swallowing function. This method has shown success rates between 43% and 100% in patients with dysphagia. However, well-designed randomised controlled trials are needed to further verify its efficacy and safety.
Balloon dilation is a widely used clinical practice for treating neurogenic dysphagia. This method involves using a catheter balloon to dilate the cricopharyngeal muscle and improve swallowing function. While it has been found to be effective for some patients, others may not see an improvement in their swallowing function even after prolonged balloon dilation.
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The muscle is located in the inferior constrictor
The cricopharyngeus muscle is located in the inferior constrictor. It is a component of the upper oesophageal sphincter, which is formed by the cricopharyngeal muscle and ends with the lower oesophageal sphincter. The cricopharyngeal muscle is responsible for keeping the oesophageal inlet closed, except during swallowing. When food approaches, the muscle relaxes and opens, allowing food to pass from the pharynx into the oesophagus.
The cricopharyngeal muscle is innervated by branches of the vagus nerves and the recurrent laryngeal nerve. It is supplied by the recurrent and external laryngeal nerves. The cricopharyngeal muscle is also associated with the glossopharyngeal nerve, which supplies the mucosa.
Dysfunction of the cricopharyngeal muscle can cause dysphagia, or difficulty swallowing. This may manifest as coughing or choking when eating or drinking, a gurgly-sounding voice, drooling, food or liquid spilling from the mouth, or lengthy meal times. Diagnosis of cricopharyngeal dysfunction can be accomplished through visual examination, revealing food or saliva pooled at the back of the throat, or through more advanced methods such as esophageal manometry, a modified barium swallow study, or a videofluoroscopic swallow study.
Treatment for cricopharyngeal dysfunction includes nonsurgical methods such as balloon dilation, botulinum toxin injections, and cricopharyngeal myotomy. Balloon dilation involves passing a catheter with a balloon at the end through the mouth and into the oesophagus, then inflating the balloon to enlarge the opening. Botulinum toxin injections serve to temporarily paralyse the muscle, allowing food to pass more easily. Cricopharyngeal myotomy involves cutting the muscle to prevent it from over-tightening and blocking food from entering the oesophagus.
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Frequently asked questions
The cricopharyngeal muscle is a muscular constrictor that acts as an upper oesophageal sphincter.
The cricopharyngeal muscle relaxes and opens when food approaches, allowing food to pass from the pharynx into the oesophagus. It then immediately closes, preventing the flow of food back into the mouth.
Cricopharyngeal dysfunction occurs when the cricopharyngeal muscle refuses to relax fully, blocking food from the oesophagus.
Cricopharyngeal dysfunction can be treated with a cricopharyngeal myotomy, a procedure in which the muscle is cut to allow the sphincter to relax and food to pass through. Botox injections can also be used to weaken the muscle and allow food to pass more easily.
Symptoms of cricopharyngeal dysfunction can include coughing or choking when eating and/or drinking, a gurgly sounding voice, drooling, food or liquid spilling from the mouth, and lengthy meal times.
