European Archives of Oto-Rhino-Laryngology

, Volume 249, Issue 4, pp 216–223

Muscle pathology in idiopathic cricopharyngeal dysphagia

Enzyme histochemical and electron microscopic findings
  • E. Laurikainen
  • K. Aitasalo
  • P. Halonen
  • B. Falck
  • H. Kalimo
Original investigations

DOI: 10.1007/BF00178473

Cite this article as:
Laurikainen, E., Aitasalo, K., Halonen, P. et al. Eur Arch Otorhinolaryngol (1992) 249: 216. doi:10.1007/BF00178473

Summary

The structural changes in the cricopharyngeal muscle (CM) were examined ultrastructurally and by enzyme histochemistry in five patients suffering from idiopathic cricopharyngeal dysphagia (ICD). Diagnosis was established by fiberoptic esophagoscopy, esophageal manometry and cineradiography. Cricopharyngeal myotomy was performed with marked improvement in all patients. Intraoperatively, a biopsy was taken from the CM. Additionally, all patients underwent neurological examination for possible generalized muscle disease, and a biopsy was taken from a limb muscle. CM from nine cadavers without known history of dysphagia served as control. The control samples disclosed structural changes which were considered to be pathological in other skeletal muscles, and required that the criteria for CM pathology we modified accordingly. In three patients changes in CM histology suggested specific pathogenesis: one patient had evidence for a generalized myositis but was only symptomatic for dysphagia. Another patient had muscle fiber atrophy and slight inflammation in her CM, possibly due to alcohol abuse. The third patient had loss of CM fibers with replacement by connective tissue enough to cause functional disturbances. In two patients no cause for dysphagia was found in either immunohistochemistry or electron microscopic studies. These results demonstrate the special structural features of the CM and indicate that ICD can have multiple etiologies.

Key words

Cricopharyngeal dysphagiaMuscle biopsyElectron microscopyEnzyme histochemistryMyositis

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • E. Laurikainen
    • 1
  • K. Aitasalo
    • 1
  • P. Halonen
    • 3
  • B. Falck
    • 4
  • H. Kalimo
    • 2
  1. 1.Department of OtorhinolaryngologyThe University of Turku and Turku University Central HospitalTurkuFinland
  2. 2.Department of PathologyThe University of Turku and Turku University Central HospitalTurkuFinland
  3. 3.Department of NeurologyThe University of Turku and Turku University Central HospitalTurkuFinland
  4. 4.Department of Clinical NeurophysiologyThe University of Turku and Turku University Central HospitalTurkuFinland
  5. 5.Department of OtolaryngologyKresge Hearing Research InstituteAnn ArborThe University of MichiganUSA