[DYSPHAGIA] cricopharyngeal spasms

[ppalmer@medonline.com (Phyllis Palmer)]

Pam,

Opening of the UES is accomplished by passive stretch due to hyolaryngeal
elevation, widening from intrabolus pressure, and relaxation of the CP
muscle. I would want to know more about what he saw at teh level of the
UES and what led him to diagnose a spasm. Did he do EMG durign swallowing
to not CP relaxation patterns? While I am sure the answer is no, I say
this because I am not certain that you can tell the CP is spasming from
susopending a scope in the pharynx (at least I can't)...you guys who do
lots of scoping, what is your experience with being able to identify
dysfunction of the CP muscle within the UES.

If the problem is related to CP relaxation then some docs may consider
botox or bougie before they consider myotomy. If the issue is relatred to
either of the other 2 components of the UES opening, you have some rx
techniques you can try,

Woudl love to hear how others deal with prominent CP muscles...or what
folks do when they see a CP bar on video?

Phyllis


On Thu, 8 Mar 2001, Larry/Pam Seibert wrote:

> Am scheduled to see a quadraplegic tomorrow who is on a cuffless trach
> and was recently scoped because he started having trouble swallowing
> solids.  He complained that there was difficulty at the level of the
> trach.  He was on a regular diet for years prior to this.
>
> When scoped the physician ordered 2 months of speech therapy to
> strengthen the swallow before considering a myotomy.  A spasm was noted
> at the level of the cricophayngus.
>
> I haven't done much of this before and would appreciate anyone's advice
> on such a case.
>
> Pam
>
> ---------------------------------------------------------------------
> To UNSUBSCRIBE from this list, please send an e-mail message to
> majordomo@medonline.com with the following text as a message:
> unsubscribe dysphagia
> ---------------------------------------------------------------------
>

-- 
__________________________________________________________
Phyllis M. Palmer, Ph.D.       Speech Language Pathologist
               www. dysphagia.com
__________________________________________________________

---------------------------------------------------------------------
To UNSUBSCRIBE from this list, please send an e-mail message to
majordomo@medonline.com with the following text as a message:
unsubscribe dysphagia
---------------------------------------------------------------------