Elliott R C
Bryanston Veterinary Hospital, PO Box 67092, Bryanston, 2021 South Africa.
J S Afr Vet Assoc. 2010 Jun;81(2):75-9. doi: 10.4102/jsava.v81i2.108.
Cricopharyngeal achalasia is a rare cause of dysphagia in the dog. However it must be differentiated from other causes of dysphagia as it is treatable with surgery. It is a disruption of the cricopharyngeal phase of the oropharyngeal phase of deglutition. There appears to be an incoordination in the swallowing process between the relaxation of the rostral, middle pharyngeal muscles and the caudal pharyngeal muscles. It is seen as a primary condition in young animals presenting soon after weaning onto solid food. The dogs appear clinically healthy unless there is secondary aspiration pneumonia or emaciation. These dogs may present as respiratory emergencies and require intensive support and treatment prior to corrective surgery. The diagnosis is made on videofluoroscopy. The condition carries a good prognosis for cure with surgical myectomy of the cricopharyngeal muscle and the thyropharyngeal muscle, which make up the upper oesophageal sphincter. Temporary relief prior to surgery can be achieved by injection of the cricopharyngeal muscle with botulism toxin. Surgical treatment for dysphagia secondary to an underlying neurological, neuromuscular or pharyngeal weakness carries a guarded prognosis and will make aspiration pneumonia worse.
环咽肌失弛缓症是犬吞咽困难的罕见原因。然而，由于它可通过手术治疗，因此必须与其他吞咽困难的原因相鉴别。它是口咽吞咽期环咽肌阶段的一种紊乱。在吞咽过程中，似乎在咽前部、中部肌肉与咽后部肌肉的松弛之间存在不协调。它在断奶后不久开始食用固体食物的幼龄动物中表现为原发性疾病。除非出现继发性吸入性肺炎或消瘦，这些犬在临床上看起来是健康的。这些犬可能以呼吸急症就诊，在进行矫正手术前需要强化支持和治疗。诊断通过视频荧光透视检查做出。通过对构成食管上括约肌的环咽肌和甲咽肌进行手术性肌切除术，该病的治愈预后良好。在手术前，通过向环咽肌注射肉毒杆菌毒素可实现暂时缓解。由潜在的神经、神经肌肉或咽部无力继发的吞咽困难的手术治疗预后不佳，且会使吸入性肺炎恶化。
