Cricopharyngeal Dysfunction

Cricopharyngeal dysfunction occurs when the muscle at the top of the esophagus, sometimes known as the upper esophageal sphincter (UES), doesn't relax to allow food to enter the esophagus or it relaxes in an uncoordinated manner. This can cause dysphagia, or difficulty swallowing. Children with cricopharyngeal dysfunction may also experience symptoms such as aspiration, choking, noisy breathing and regurgitation when they try to eat or drink.

What are the symptoms of cricopharyngeal dysfunction?

Cricopharyngeal dysfunction can cause a number of symptoms in babies and children. These include:

• dysphagia
• aspiration
• choking
• coughing
• cyanosis (blue spells)
• recurrent pneumonia
• nasal congestion

What causes cricopharyngeal dysfunction?

Cricopharyngeal dysfunction occurs when the UES doesn't relax properly.

How is cricopharyngeal dysfunction diagnosed?

Physicians typically diagnose cricopharyngeal dysfunction using high-resolution manometry with impedance.

How is cricopharyngeal dysfunction treated?

Depending on your child's unique situation, the physician will likely recommend less-invasive approaches to treat cricopharyngeal dysfunction. These approaches may include:

• dilation
• injections of botulinum toxin (Botox) to help relax the UES

How we care for cricopharyngeal dysfunction

The skilled clinicians in the Aerodigestive Center at Boston Children's Hospital are experienced in diagnosing and treating children with a range of aerodigestive concerns, including cricopharyngeal dysfunction. Using high-resolution esophageal manometry with impedance, we are able to precisely determine the relationship between sphincter relaxation and food and liquid movement into the esophagus. As the only aerodigestive center with motility specialists as an integral part of the team, we are able to diagnose and treat patients with this sphincter dysfunction.