Watanabe Toshihiko, Shimizu Takahiro, Takahashi Masataka, Sato Kaori, Ohno Michinobu, Fuchimoto Yasushi, Maekawa Takanobu, Arai Katsuhiro, Mizutari Kunio, Morimoto Noriko, Kanamori Yutaka
Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan.
Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan.
Int J Pediatr Otorhinolaryngol. 2014 Jul;78(7):1182-5. doi: 10.1016/j.ijporl.2014.04.036. Epub 2014 May 2.
Cricopharyngeal achalasia is an uncommon cause of dysphagia in neonates or children. A nine-year-old female patient was referred to us with a long history of dysphagia, recurrent pulmonary infection and growth stunting. A gastrostomy was introduced to improve her nutritional condition and to minimize potential inflammation in the pharynx. Subsequently, cervical cricopharyngeal myectomy was conducted. The surgical intervention allowed prompt resolution of symptoms without complications. High-resolution manometry post myectomy demonstrated a significant reduction in upper esophageal pressure together with proper relaxation at deglutition. The patient was able to consume solid food and liquid normally, and remained asymptomatic without medications six months after the surgery.
环咽肌失弛缓症是新生儿或儿童吞咽困难的罕见原因。一名9岁女性患者因长期吞咽困难、反复肺部感染和生长发育迟缓前来就诊。置入胃造口术以改善其营养状况并尽量减少咽部潜在炎症。随后，进行了颈部环咽肌切除术。手术干预使症状迅速缓解且无并发症。肌切除术后的高分辨率测压显示食管上段压力显著降低，吞咽时松弛正常。患者术后6个月能够正常食用固体食物和液体，无需药物治疗且无症状。
