[DYSPHAGIA] cricopharyngeal spasms

[pbates@sunflower.com (Pat Bates)]

CP bar?...First consider the case history but I immediately think
esophageal. We scan down the esophagus if we can, and refer for an
esophagram, upper GI and /or GI consult for EGD if indicated.
Pat
----- Original Message -----
From: "Phyllis Palmer" <ppalmer@medonline.com>
To: "Larry/Pam Seibert" <lpseibert@home.com>
Cc: <dysphagia@medonline.com>
Sent: Saturday, March 10, 2001 11:22 PM
Subject: Re: [DYSPHAGIA] cricopharyngeal spasms


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