Author(s)
Peter Larner, MD
Lauren Boeckermann, MD MPH
Cody Anderson, MD
Marshall Smith, MD
Affiliation(s)
University of Utah
Abstract:
Background
The prevalence of retrograde cricopharyngeal dysfunction (R-CPD) has increased since first described in 2019. Exposure of the cricopharyngeal muscle for operative treatment presents a challenge, as existing laryngoscopes and esophagoscopes were not designed to provide exposure of this region. This study aims to describe anatomic relationships that might facilitate better exposure of this area.
Methods
Measurements were obtained of the distance from the central incisors (CI) to the vocal folds (VF) and to the cricopharyngeal muscle (CM) from patients undergoing endoscopic laryngological procedures at a single institution over a two-year period (N=72). Demographic data were also collected including age, weight, height, and body mass index (BMI).
Results
Median CI-CM distance was 147.5 millimeters (95% confidence interval 144.7-150.3 mm), and the range was 122-178 mm. Pearson correlations were calculated between individual variables including height, weight and BMI and CI-CM and CI-VF distance. Positive correlations were identified between height and CI-CM distance (r (70) = 0.53, p < 0.001) as well as CI-VF and CI-CM distance (r (70) = 0.86, p < 0.001). No correlation was identified between weight and CI-CM or BMI and CI-CM.
Conclusions: Inadequate surgical exposure presents a challenge for endoscopic treatment of (R-CPD) and other upper esophageal pathologies. Understanding the normative anatomy of the upper aerodigestive tract is essential to facilitate endoscopic exposure of the cricopharyngeus muscle. This can aid in preoperative planning and endoscope selection.