Upper esophageal sphincter function in patients with Zenker's diverticulum

Dysphagia ◽  
1988 ◽  
Vol 3 (2) ◽  
pp. 90-92 ◽  
Author(s):  
T. Frieling ◽  
W. Berges ◽  
H. J. Lübke ◽  
P. Enck ◽  
M. Wienbeck
Keyword(s):  
Upper Esophageal Sphincter ◽  
Zenker’S Diverticulum ◽  
Sphincter Function ◽  
Zenker's Diverticulum ◽  
Esophageal Sphincter

Pharyngeal (Zenker's) diverticulum is a disorder of upper esophageal sphincter opening

1992 ◽  
Vol 103 (4) ◽  
pp. 1229-1235 ◽  
Author(s):  
Ian J. Cook ◽  
Mary Gabb ◽  
Voula Panagopoulos ◽  
Glyn G. Jamieson ◽  
Wylie J. Dodds ◽  
...  
Keyword(s):  
Upper Esophageal Sphincter ◽  
Zenker’S Diverticulum ◽  
Zenker's Diverticulum ◽  
Esophageal Sphincter

Biomechanics of failed deglutitive upper esophageal sphincter relaxation in neurogenic dysphagia

2002 ◽  
Vol 283 (1) ◽  
pp. G16-G26 ◽  
Author(s):  
Rohan B. H. Williams ◽  
Karen L. Wallace ◽  
Galib N. Ali ◽  
Ian J. Cook
Keyword(s):  
Biomechanical Properties ◽  
Upper Esophageal Sphincter ◽  
Zenker’S Diverticulum ◽  
Bolus Volume ◽  
Neurogenic Dysphagia ◽  
Zenker's Diverticulum ◽  
Pharyngeal Swallow ◽  
Extrapyramidal Disease ◽  
Esophageal Sphincter ◽  
Ues Opening

Our aims were to examine the etiology and biomechanical properties of the nonrelaxing upper esophageal sphincter (UES) and the relationship between UES opening and failed relaxation. We examined the relationships among swallowed bolus volume, intrabolus pressure, sagittal UES diameter, the pharyngeal swallow response, and geniohyoid shortening in 18 patients with failed UES relaxation, 23 healthy aged controls, and 15 with Zenker's diverticulum. Etiology of failed UES relaxation was 56% medullary disease, 33% Parkinson's or extrapyramidal disease; and 11% idiopathic. Extent of UES opening ranged from absent to normal and correlated with preservation of the pharyngeal swallow response ( P = 0.012) and geniohyoid shortening ( P = 0.046). Intrabolus pressure was significantly greater compared with aged controls ( P < 0.001) or Zenker's diverticulum ( P < 0.001). The bolus volume-dependent increase in intrabolus pressure evident in controls was not observed in failed UES relaxation. The nonrelaxing UES therefore displays a constant loss of sphincter compliance throughout the full, and potentially normal, range of expansion during opening. Adequacy of UES opening is influenced by the degree of preservation of the pharyngeal swallow response and hyolaryngeal traction. In contrast, the stenotic UES displays a static loss of compliance, only apparent once the limit of sphincter expansion is reached.

Biochemical Markers of Upper Esophageal Sphincter Compliance in Patients with Zenker's Diverticulum

1997 ◽  
Vol 70 (1) ◽  
pp. 46-48 ◽  
Author(s):  
Marco Venturi ◽  
Luigi Bonavina ◽  
Laura Colombo ◽  
Laura Antoniazzi ◽  
Alessandra Bruno ◽  
...  
Keyword(s):  
Biochemical Markers ◽  
Upper Esophageal Sphincter ◽  
Zenker’S Diverticulum ◽  
Zenker's Diverticulum ◽  
Esophageal Sphincter

Disorders Involving the Pharynx and Upper Esophagus

2016 ◽  
Author(s):  
Hiroshi Mashimo
Keyword(s):  
Viral Infections ◽  
Oropharyngeal Dysphagia ◽  
Neuromuscular Control ◽  
Upper Esophageal Sphincter ◽  
Peritonsillar Abscess ◽  
Zenker’S Diverticulum ◽  
Zenker's Diverticulum ◽  
Globus Pharyngeus ◽  
Submental Muscles ◽  
Esophageal Sphincter

A wide variety of disorders can affect the pharynx and upper esophagus, such as inherited or acquired structural abnormalities, malignancies, and inflammation secondary to a number of etiologies including bacterial, yeast and viral infections, irradiation, and gastroesophageal reflux disorder. Laryngoceles and peritonsillar abscess can also lead to pain and dysfunction. However, this review will focus on the main motility disorders that affect the pharynx and upper esophagus, namely oropharyngeal dysphagia, disorders associated with globus pharyngeus, and Zenker’s diverticulum. Figures show the anatomy of the three stages of normal swallow, various findings on functional endoscopic evaluation of swallowing, electromyography of the cricopharyngeal sphincter and submental muscles, and Zenker’s diverticulum. Tables list causes of oropharyngeal dysphagia, neuromuscular control of the pharyngeal phase (with identified cranial and cervical spinal nerve roots), pathophysiology of oropharyngeal dysplasia, diagnostic tests for oropharyngeal dysplasia, behavioral treatments to improve swallow and reduce aspiration, and potential overlapping causes of impaired upper esophageal sphincter relaxation.   This review contains 4 highly rendered figures, 6 tables, and 40 references   Key words: Oropharyngeal dysphagia; Globus; Upper esophageal sphincter dysfunction; Swallowing disorder; Dysphagia; Zenker’s diverticulum; Swallow assessment; Globus pharyngeus

Influence of mucosal receptors on deglutitive regulation of pharyngeal and upper esophageal sphincter function

1994 ◽  
Vol 267 (4) ◽  
pp. G644-G649 ◽  
Author(s):  
G. N. Ali ◽  
T. M. Laundl ◽  
K. L. Wallace ◽  
D. W. Shaw ◽  
D. J. Decarle ◽  
...  
Keyword(s):  
Sensory Input ◽  
Upper Esophageal Sphincter ◽  
Sensory Receptors ◽  
Potential Influence ◽  
Sphincter Function ◽  
Temporal Regulation ◽  
Wave Characteristics ◽  
Pharyngeal Swallow ◽  
Esophageal Sphincter ◽  
Contraction Wave

The potential influence of mucosal sensory receptors on the regulation of oral-pharyngeal swallow events was studied in 15 healthy volunteers using simultaneous videoradiography and manometry. We determined the effects of selective pharyngeal and oral plus pharyngeal anesthesia on the following temporal and manometric measures in response to liquid and viscous swallows: regional transit and clearance times; motion of hyoid and larynx; upper esophageal sphincter relaxation, opening, and closure; and pharyngeal contraction wave characteristics. Under the influence of mucosal anesthesia no subjects demonstrated aspiration during deglutition. Neither regional transit and clearance times nor pharyngosphincteric coordination was influenced significantly by pharyngeal mucosal anesthesia or oral plus pharyngeal anesthesia. Although midpharyngeal and distal pharyngeal contraction amplitudes were not influenced by mucosal anesthesia, midpharyngeal contraction wave duration was reduced significantly by both pharyngeal (P = 0.02) and oral plus pharyngeal anesthesia (P = 0.0005). We conclude that 1) neither elicitation of the pharyngeal swallow response nor temporal regulation among swallow events is dependent on mucosal sensory receptors and 2) duration of the pharyngeal contraction is influenced by sensory input from the oral-pharyngeal mucosa.

Upper esophageal sphincter function during gastroesophageal reflux events revisited

2000 ◽  
Vol 279 (2) ◽  
pp. G262-G267 ◽  
Author(s):  
Silvia Torrico ◽  
Mark Kern ◽  
Muhammad Aslam ◽  
Subashini Narayanan ◽  
Ananda Kannappan ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Esophageal Pressure ◽  
Upper Esophageal Sphincter ◽  
Pressure Increase ◽  
Sphincter Function ◽  
Average Percentage ◽  
Control Subjects ◽  
Asymptomatic Volunteers ◽  
Esophageal Sphincter ◽  
Intraesophageal Pressure

Upper esophageal sphincter (UES) function during gastroesophageal reflux events is not completely elucidated because previous studies addressing this issue yielded conflicting results. We reexamined the UES pressure response to intraluminal esophageal pressure and pH changes induced by reflux events. We studied 14 healthy, asymptomatic volunteers (age 49 ± 6 yr) and 7 gastroesophageal reflux disease patients (age 48 ± 5 yr). UES pressure, intraesophageal pressure, and pH were monitored at the distal, middle, and proximal esophagus concurrently in the supine position 1 h before and 2 h after a 1,000-calorie meal. A total of 321 reflux events were identified by the development of abrupt reflux-induced intraesophageal pressure increase (IPI); 285 events occurred in patients and 36 in control subjects. In control subjects 33 of 36 and in patients 252 of 285 IPI events were associated with a pH drop. Among patients and control subjects, 99% and 100%, respectively, of all IPI events irrespective of pH drop were associated with abrupt increase in UES pressure (34 ± 2 and 27 ± 6 mmHg, respectively). The average percentage of maximum UES pressure increase over prereflux values ranged between 66% and 96% (control subjects) and 34% and 122% (patients). IPIs induced by both acidic and nonacidic reflux events evoke strong UES contractile responses.

Upper esophageal sphincter function during deglutition

1988 ◽  
Vol 95 (1) ◽  
pp. 52-62 ◽  
Author(s):  
P.J. Kahrilas ◽  
W.J. Dodds ◽  
J. Dent ◽  
J.A. Logemann ◽  
R. Shaker
Keyword(s):  
Upper Esophageal Sphincter ◽  
Sphincter Function ◽  
Esophageal Sphincter

The Cricopharyngeus in the Neonate

1980 ◽  
Vol 89 (5) ◽  
pp. 446-449 ◽  
Author(s):  
Timothy J. Reichert ◽  
Kenneth D. Faw
Keyword(s):  
Upper Esophageal Sphincter ◽  
Airway Protection ◽  
Sphincter Function ◽  
Cricopharyngeus Muscle ◽  
Total Length ◽  
Esophageal Sphincter ◽  
Neonates And Infants

The cricopharyngeus muscle in neonates and infants has not been well established. It is found, like other laryngopharyngeal structures in infants, to be relatively much larger than its counterpart in the adult but not large enough to correlate with the total length of reported sphincter function. It also varies significantly in size, and therefore probably does not contribute completely to the function of the upper esophageal sphincter. Its relationship to airway protection, regurgitation and respiration needs to be more thoroughly studied.

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