Cricopharyngeus muscle dysfunction: a poorly defined disorder from diagnosis to treatment

• Published in: European archives of oto-rhino-laryngology Vol. 281; no. 9; pp. 4519 - 4527
• Main Authors: Krekeler, Brittany N., Howell, Rebecca J.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2024
• Subjects: Deglutition Disorders - diagnosis; Deglutition Disorders - etiology; Deglutition Disorders - physiopathology; Deglutition Disorders - therapy; Head and Neck Surgery; Humans; Medicine; Medicine & Public Health; Neurosurgery; Otorhinolaryngology; Pharyngeal Muscles - physiopathology; Review Article; Cricopharyngeus; Treatment; Swallowing; Laryngology
• ISSN: 0937-4477; 1434-4726; 1434-4726
• DOI: 10.1007/s00405-024-08644-7

Purpose Cricopharyngeus muscle dysfunction (CPMD) is a common clinical occurrence with very few clear diagnostic criteria and multiple pathways for treatment. Incidence of CPMD is not known, but some data suggest around 25% of people with dysphagia experience some degree of CPMD, which negatively impacts swallowing safety and efficiency. Workup and treatment of CPMD can require multidisciplinary collaboration across laryngologists, speech-language pathologists with training in dysphagia management, and gastroenterologists. The purpose of this paper is to review what is known about CPMD and identify areas of future research in CPMD diagnosis and treatment. Methods An overview of CPMD, relative treatments and disorders, and a discussion of future areas of research needed to improve clinical care of CPMD. Results Details regarding historical background, pathophysiology and treatment practiced for CPMD are included. Conclusion In summary, CPMD is a poorly defined disease due to a lack of understanding of its pathophysiology and the lack of consensus diagnostic criteria. Well-designed, prospective clinical trials are necessary to develop a better understanding of clinical incidence of CPMD, impact of the disorder on oropharyngeal swallowing, and how to approach treatment of the disorder surgically or in conjunction with therapy directed by a specialized speech-language pathologist.