Cricopharyngeal myotomy for cricopharyngeus stricture in an inclusion body myositis patient with hiatus hernia: a learning experience.

Abstract

Inclusion body myositis is a chronic progressive myopathy which tends not to respond to steroids and immunosuppressive treatments. Dysphagia is more common in this group than other inflammatory myopathies like polymyositis and dermatomyositis. Otolaryngologists are involved in the management of dysphagia in inclusion body myositis. They usually use a combination of cricopharyngeal myotomy, upper oesophageal dilation or botulinum injection to help with the symptoms. Cricopharyngeus myotomy is the preferred treatment in this group and patients tend to be discharged after a short stay in the hospital. However, our experience was completely different from what we expected as a relatively straightforward procedure led to severe morbidity and prolonged hospital admission due to continuous acid reflux and aspiration. We believe that the presence of hiatus hernia led to this problem as the patient's problem resolved completely after her hernia was treated.

• Authors: Ali Sanei-Moghaddam, Sanjiv Kumar, Piyush Jani, Charlotte Brierley
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2013 (Jan 22 2013) ISSN: 1757-790X [Electronic] England
• PMID: 23345496 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Biopsy
• Constriction, Pathologic (complications, surgery)
• Diagnosis, Differential
• Endoscopy (methods)
• Female
• Hernia, Hiatal (complications, diagnosis)
• Humans
• Myositis, Inclusion Body (complications, diagnosis, surgery)
• Pharyngeal Muscles (surgery)
• Radiography, Thoracic