Pharyngeal findings in 21 patients with achalasia of the esophagus

Dynamic imaging of the pharynx revealed unsuspected pharyngeal findings in 11 of 21 consecutive patients with achalasia of the esophagus. Findings included cricopharyngeal prominence, asymmetry of pharyngeal contraction or epiglottic tilt, and lateral pharyngel pouches, many of which emptied postswallow into the pyriform sinus, resulting in retention of contrast. Two patients had a Zenker's diverticulum; a Zenker's diverticulum had been resected 10 years previously in a third. There may be a causal relationship between these pharyngeal findings and the esophageal disease. In achalasia, it is important to examine the pharynx in addition to the esophagus, so that pharyngeal findings will not be overlooked.