Author(s)
Omid B. Mehdizadeh
Peter Wickwire
Mena Said
Peter C. Belafsky
Affiliation(s)
University of California at Davis School of Medicine; CA
Abstract:
Objective: Cricopharyngeal webs (CPW) are a frequent cause of solid food dysphagia. They are difficult to diagnose and are often missed on swallowing fluoroscopy. The prevalence of CPWs is uncertain. The purpose of this investigation was to determine the prevalence of CPWs in elderly cadavers.Method: Direct laryngoscopy and cervical esophagoscopy was performed in 19 embalmed cadavers. Patient demographics and the presence and laterality of a CPW were recorded. Web prevalence was confirmed by two-physician consensus. The prevalence of CPW was calculated and the size of the cricopharyngeus muscle (CPM) was quantified.Results: The mean age of the cohort was 83 (+/-12) years. 53% was female and the mean BMI was 19.7 (+/-3). The causes of death were cardiovascular disease (10/19), cancer (5/19), and respiratory failure (4/19). A cricopharyngeal web was present in 68% (13/19) of cadavers. 47% (9/19) had a unilateral web and 21% (4/19) had a bilateral web. There was no laterality predominance (p > 0.05). 42% (8/19) had no CPM prominence, 32% (6/19) had a small and 26% (5/19) had a significant CPM prominence.Conclusion: The prevalence of cricopharyngeal webs in elderly cadavers is high (68%). Clinicians should maintain a high index of suspicion for CPWs in elderly patients with no other identifiable etiology of obstructive solid food dysphagia.