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Management With Botulinum Toxin Before Myotomy

Ryan K. Sewell, MD, JD; Nancy M. Bauman, MD

Arch Otolaryngol Head Neck Surg. 2005;131:451-453.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

Cricopharyngeal (CP) achalasia is a rare condition of unknown etiology in which the upper esophageal sphincter (UES) fails to open properly during deglutition.¹ The normal UES is tonically closed to prevent the inflow of air into the esophagus during inspiration and the regurgitation of food from the esophagus back into the pharynx.^2-3 The UES briefly relaxes during deglutition, belching, or emesis.²

Cricopharyngeal achalasia is a well-described condition in adults, with symptoms including dysphagia, expectoration of excess saliva, hoarseness, and regurgitation.⁴ In infants, however, CP achalasia is exceedingly rare and potentially life-threatening.⁵ Presenting signs include difficulty in feeding, regurgitation, coughing, nasal reflux, and failure to thrive.¹ We describe a neonate in whom botulinum toxin was used for the temporary resolution of CP achalasia.

REPORT OF A CASE

A 3210-g boy was delivered after 38 weeks of gestation to a 22-year-old gravida 2, para 2 woman. The . . . [Full Text of this Article]

COMMENT

CONCLUSIONS

AUTHOR INFORMATION

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City. Dr Sewell is now with the Department of Otolaryngology–Head and Neck Surgery, University of Nebraska Medical Center, Omaha.