2 Indications and current treatments
2.1 Cricopharyngeal (CP) muscle dysfunction, also known as dysfunction of the upper oesophageal sphincter, occurs when the CP sphincter muscle fails to relax and open during swallowing. This may be caused by muscular or degenerative neurological disorders, or after head and neck surgery, or it may be idiopathic. Symptoms of CP muscle dysfunction include difficulty swallowing, painful swallowing, choking, regurgitation, cough, aspiration and weight loss.
2.2 Treatment for CP muscle dysfunction includes procedures such as swallowing rehabilitation therapy and dilatation of the oesophagus, and medical management with muscle relaxants or botulinum toxin injections. If symptoms persist, open surgery through a neck incision (transcervical CP myotomy) may be done. Endoscopic CP myotomy using diathermy, laser (such as carbon dioxide or potassium titanyl phosphate laser) or stapling techniques, is a less invasive alternative to open surgery.