The sharp metal parts of the tooth were lodged in the cricopharyngeal
Usually, the foreign bodies are stuck at an inch below the cricopharyngeal
sphincter because strong propulsive pharyngeal muscles can force an object up to that level and further down the oesophageal musculature cannot propel the foreign body with the same intensity.
In the case of oesophageal impaction, a chest radiograph will reveal a smooth, round object, most commonly lodged in the cricopharyngeal
area, in the middle third of the oesophagus where the left main bronchus crosses the oesophagus (as this is anatomically the most narrow part of the oesophagus) or at the lower oesophageal sphincter.
Boerhaave syndrome refers to esophageal rupture that occurs with vomiting secondary to incomplete cricopharyngeal
muscle relaxation and increased intraluminal pressure.
2000)  investigated the pathophysiology of dysphagia in amyotrophic lateral sclerosis (ALS) by clinical and electrophysiological measurements such as: larynx displacement from a piezoelectric sensor; electromyographic activity surface of suprahyoid muscles (EMG-MSH) and intramuscular electromyographic activity of the cricopharyngeal
muscle (SMEI through needle electrodes) during swallowing of different water volumes (Table 1 and 2).
OD symptoms included cricopharyngeal
dysfunction, reduced oesophageal motility, GOR, tracheo-oesophageal fistula, oesophagitis and obstruction of the oesophagus.
Balci AE, Eren S, Eren MR Esophageal foreign bodies under cricopharyngeal
level in children: an analysis of 1116 cases.
Table 1: Aetiological factors for dysphagia Diagnostic Group Example Neurological Stroke Sub Arachnoid Haemorrhage Multiple Sclerosis Motor Neuron Disease Brain tumour Traumatic Brain Injury Encephalitis Post Polio Syndrome Developmental problems (Cleft palate) Musculoskeletal Cervical Osteophytes Spondylolisthesis Rheumatoid arthritis Disc Prolapse Malignancy Tongue Gum Larynx Pharynx Oesophagus Infection Candida Streptococcal Cardio respiratory Heart Failure COPD Lung Fibrosis Iatrogenic Post intubation Post surgery Other Pharyngeal pouch Pharyngeal atresia/stenosis Cricopharyngeal
spasm Oesophageal atresia Oesophageal achalasia Frailty Medication Anticholinergic medication Antibiotics Opiates Anti psychotics Benzodiazepines Calcium Channel Blockers Self Harm Bleach Fire
The etiology of dysphagia after stroke is multifactorial, but one of the most common reasons is motor dysfunction, which includes the absence or delay in the triggering of the swallowing reflex, cricopharyngeal
dysfunctions, reduced lingual control, reduced gag reflex, and reduced strength of pharyngeal contraction (24-26).
Finally, the pouch was excised using a 60-mm stapler, and a wide cricopharyngeal
myotomy was performed.
The site of the foreign body impaction was at the level of cricopharyngeal
sphincter in 39 (68.
Video laryngoscopy [Figure 1]a revealed a mobile right vocal fold, extensive granulomatous tissue formation involving the full length of the left vocal cord, obstructing the whole glottic lumen in the inspiratory phase, and an opene cricopharyngeal
lumen [Figure 1]a, both in the inspiratory and expiratory phases, through which a TEF (2 cm on its esophageal side) was revealed by flexible endoscopy [Figure 1]b.