Cricopharyngeal Myotomy and Operation for Pharyngoesophageal (Zenker’s) Diverticulum

Abstract

Normal swallowing begins when the tongue thrusts a bolus of food from the mouth back into the pharynx. When food contacts the pharyngeal mucosa, it initiates afferent impulses to the swallowing center in the medulla. The swallowing center promptly sends an orderly sequence of impulses to the muscles of the pharynx, the esophagus, and the stomach. Forceful contraction of the pharyngeal musculature closes the passageway between the mouth and the nasopharynx to prevent regurgitation into the nose while at the same time the food is propelled forward. At this instant the cricopharyngeal sphincter must relax until the bolus of food has passed into the esophagus where sequential peristaltic contractions carry the food toward the stomach. At the lower end of the esophagus, the lower esophageal sphincter relaxes for a few seconds to permit the food to pass.