New York, NY (January 2009) -- Difficulty swallowing, or dysphagia, affects up to one in five people over 50 years of age, according to the American Speech-Language-Hearing Association. Many of these people cannot swallow because of a dysfunctional muscle that surrounds the top of the esophagus and, as a result, 10,000 people per year receive a corrective surgical procedure called a cricopharyngeal myotomy, videoaccording to National Hospital Discharge Survey data.
Open surgery to cut through the crescent-shaped muscle, and allow the passage of food, has been the standard for years, but a new comprehensive study in the January, 2009 issue of the professional journal Laryngoscope, argues that less invasive endoscopic CO2 laser surgery may be preferable today.
According to the authors, Michael Pitman, MD and Philip Weissbrod, MD, both at the New York Eye and Ear Infirmary, endoscopic cricopharyngeal myotomy (ECPM) is safe, reliable and just as effective as the open surgery procedure. ECPM also produces no external scar, reduces surgical, anesthesia and recovery time and has a lower risk with re-operation after a previous open surgery.
“The expanding availability of electronic medical publishing has made it possible for authors to supplement their written review not only with additional appendices and color illustrations, but with online video demonstrations. In this case, the authors hope the video will encourage surgeons to consider ECMP,” said Jonas T. Johnson, MD, editor of Laryngoscope.
“Because comparatively few surgeons have performed the endoscopic procedure, we included a video of the operation so a much larger audience of surgeons can see how it is done,” said Dr. Pitman, director of New York Eye and Ear Infirmary’s Voice & Swallowing Institute. “ECPM has yet to be popularized due to apprehension of learning the endoscopic technique and for fears of mediastinitis (inflammation of tissues in the chest). The video reassures surgeons and other viewers on both counts.”
The type of swallowing problem caused by dysfunction of the cricopharyngeus (CP) muscle is called cricopharyngeal achalsia. The traditional, open surgical technique is called transcervical cricopharyngeal myotomy (TCPM).
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