To the Editor.—I note with interest the recent publication of "Manometry and Electromyography of the Pharyngeal Muscles in Patients With Dysphasia" in the August 1990 issue of the Archives.1
I find this a useful analysis of the disordered swallow in a mixed population of patients. I also applaud the authors' efforts to develop a simple and cost-effective preoperative assessment for dysphasia, with particular reference to the indication for cricopharyngeal myotomy. I would like to suggest a simpler clinical assessment than the simultaneous study described.
It has been a useful technique, in my practice, to infiltrate the cricopharyngeous muscle unilaterally as a field block to test the preoperative effect of cricopharyngeal relaxation. This may, or may not, be performed using simultaneous fluoroscopy. It has been highly correlated with successful myotomy for those patients who achieve improved swallowing function for the duration of the anesthetic block.2
The upper esophageal
SINGER MI. Manometry and Electromyography of the Pharyngeal Muscles in Patients With Dysphasia. Arch Otolaryngol Head Neck Surg. 1991;117(3):340. doi:10.1001/archotol.1991.01870150108017
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