Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar

Background: The cricopharyngeal (CP) bar is an uncommon but important cause of oropharyngeal dysphagia (OPD). Treatment options include CP myotomy, which can be problematic, because CP bars primarily occur in elderly patients who are at higher risk for perioperative complications. The effectiveness of esophageal dilation for patients with symptoms caused by a CP bar is not well studied. Methods: A review of medical records (1999 to 2002) identified 32 patients with CP bar. Six of these patients who had OPD that could only be attributed to a CP bar underwent EGD and dilation with either over-the-guidewire polyvinyl dilators (5) or a balloon (1). Observations: All 6 patients experienced immediate relief of dysphagia. Five had continued improvement at short-term follow-up (1 to 4 weeks). Three patients still had complete resolution of dysphagia at long-term follow-up (range 8 to 27 months). Conclusions: CP bar is an important cause of dysphagia in elderly patients. Esophageal dilation of a CP bar can produce long-term relief of dysphagia.