Cricopharyngeal achalasia: Case reports and review of the literature

Primary cricopharyngeal achalasia (a = absence, chalasia = relaxation) is a rare cause of swallowing disorders in newborns. Two cases are reported whi ch were successfully treated by a myotomy of the cricopharyngeal muscle. A thorough history is essential in differential diagnosis as well as observat ion of the feeding infant. Presence of anatomical obstruction to swallowing and existence of neurological defects should be ruled out. Cineradiography with lateral views by an experienced radiologist is the best diagnostic te chnique. Esophageal manometry may provide information regarding other esoph ageal dyskinetic problems. However, these studies are difficult to perform in neonates and infants. Endoscopy may be helpful to exclude vocal cord par alysis or mechanical obstruction. Balloon dilatation has been reported as b eing successful in several reports: however no comparison of efficacy has b een made in any series between dilatation of the upper esophagus and surgic al myotomy which remains in our mind, the optimal treatment of cricopharyng eal achalasia.