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In Reply.—We would like to thank Dr Singer for his kind remarks. We appreciate Dr Singer's observation that improvement of a patient's swallowing function after cricopharyngeal myotomy is well correlated with his response to local block of the cricopharyngeal muscle before the operation. However, as mentioned in our article, at least part of the pressure in the upper high-pressure zone in the esophagus is due to elastic forces of the surrounding tissues. Thus, there is no substitute for actual measurement of intraluminal pressure (and the electrical activity).
It would be of interest to record these parameters before and after local infiltration, and eventually we will add this to our usual preoperative battery of tests.
ELIDAN J. Manometry and Electromyography of the Pharyngeal Muscles in Patients With Dysphasia-Reply. Arch Otolaryngol Head Neck Surg. 1991;117(3):340. doi:10.1001/archotol.1991.01870150108018