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Cricopharyngeal achalasia associated with laryngomalacia as a cause of failure to thrive

Published online by Cambridge University Press:  18 June 2018

V Givens ,
K Brent ,
M Dunham  and
S P Kanotra
V Givens
Affiliation:
Department of Otolaryngology, Louisiana State University, Children's Hospital New Orleans, USA
K Brent
Affiliation:
Department of Pediatric Gastroenterology, Louisiana State University, Children's Hospital New Orleans, USA
M Dunham
Affiliation:
Department of Otolaryngology, Louisiana State University, Children's Hospital New Orleans, USA
S P Kanotra*
Affiliation:
Department of Otolaryngology, Louisiana State University, Children's Hospital New Orleans, USA
*
Address for correspondence: Dr Sohit Paul Kanotra, Department of Pediatric Gastroenterology, Louisiana State University, Children's Hospital New Orleans, 200 Henry Clay Avenue Suite 4119, New Orleans, Louisiana 70118, USA Fax: +1 504 896 9296 E-mail: skanot@lsuhsc.edu
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Abstract

Objective

To describe a case of concurrent cricopharyngeal achalasia with laryngomalacia as a cause of failure to thrive, and to review the literature and management options of cricopharyngeal achalasia in the paediatric population.

Methods

A chart review was performed on a four-month-old male, referred for failure to thrive, and diagnosed with cricopharyngeal achalasia and laryngomalacia. A PubMed and Embase search for ‘cricopharyngeal achalasia’ and ‘laryngomalacia’ was conducted. A review of reported paediatric cricopharyngeal achalasia patients, with emphasis on management options, was undertaken.

Results

A flexible laryngoscopic examination confirmed the laryngomalacia diagnosis, and videofluoroscopic evaluation of swallowing demonstrated cricopharyngeal achalasia via a cricopharyngeal bar. Supraglottoplasty was performed, with botulinum toxin injection into the cricopharyngeus muscle, with resultant improvement in oral intake and resolution of failure to thrive. The literature review revealed no reported case of the combined pathologies as a cause of failure to thrive.

Conclusion

Functional endoscopic evaluation of swallowing and videofluoroscopic evaluation of swallowing are complimentary in the evaluation of paediatric patients with failure to thrive and suspected oropharyngeal dysphagia. Both supraglottoplasty and botulinum toxin injection are effective for definitive management in cases of combined pathology, and can be safely performed in a single surgical setting.

Keywords

AchalasiaLaryngomalaciaFailure To ThriveDysphagia
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 9 , September 2018 , pp. 852 - 855
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr S P Kanotra takes responsibility for the integrity of the content of the paper

References

1Zenel, JA Jr. Failure to thrive: a general pediatrician's perspective. Pediatr Rev 1997;18:371–8Google Scholar
2Sewell, JK, Bauman, NM. Congenital cricopharyngeal achalasia: management with botulinum toxin before myotomy. Arch Otolaryngol Head Neck Surg 2005;131:451–3Google Scholar
3Hussain, SZ, Di, LC. Motility disorders: diagnosis and treatment for the pediatric patient. Pediatr Clin North Am 2002;49:27–51Google Scholar
4Salib, SA, Aubert, D, Valioulis, I, de Billy, B. Cricopharyngeal achalasia: a cause of major dysphagia in a newborn: a case report. Eur J Pediatr Surg 1999;9:406–8Google Scholar
5Barnes, MA, Ho, AS, Malhotra, PS, Koltai, PJ, Messner, A. The use of botulinum toxin for pediatric cricopharyngeal achalasia. Int J Pediatr Otorhinolaryngol 2011;75:1210–14Google Scholar
6Brooks, A, Millar, AJ, Rode, H. The surgical management of cricopharyngeal achalasia in children. Int J Pediatr Otorhinolaryngol 2000;56:1–7Google Scholar
7Erdeve, O, Kologlu, M, Saygili, B, Atasay, B, Arsan, S. Primary cricopharyngeal achalasia in a newborn treated by balloon dilatation: a case report and review of the literature. Int J Pediatr Otorhinolaryngol 2007;71:165–8Google Scholar
8Blitzer, A, Brin, MF. Use of botulinum toxin for diagnosis and management of cricopharyngeal achalasia. Otolaryngol Head Neck Surg 1997;116:328–30Google Scholar
9Scholes, MA, McEvoy, T, Mousa, H, Wiet, G. Cricopharyngeal achalasia in children: botulinum toxin injection as a tool for diagnosis and treatment. Laryngoscope 2013;124:1475–80Google Scholar