Surgery for cricopharyngeal dysfunction under local anesthesia.

Six new instances of primary cricopharyngeal achalasia are reported. Since 1961, treatment of these as well as eight other cases of sphincter dysfunction with secondary pharyngoesophageal diverticulum has consisted of posterior division of the muscle and inversion rather than excision of the diverticulum. The validity of this approach is supported by restoration to normal or near normal swallowing based on clinical and cineradiographic evidence. The advantages of performing this surgery under local anesthesia include the opportunity to observe directly the pathophysiology of the swallowing disorder, precise division of the cricopharyngeus muscle, and the ability of this older group of patients to eat, drink, and function normally immediately after operation.