There is a divergence of opinion concerning the cricopharyngeal muscle defect commonly seen in the pharyngoesophageal area on barium esophagram. Some observers believe this defect is the result of neuromuscular dysfunction with the demonstration of the unrelaxed muscle bundle; however, others believe it is the result of actual hypertrophy of the cricopharyngeal muscle. Radiologic and pathologic study of 24 unselected autopsy cases revealed cricopharyngeal hypertrophy in 13 cases by radiologic criteria. Histologic examination revealed that the cricopharyngeal muscle thickness was uniformly greater in these cases than in the radiographically normal cases. The cricopharyngeal muscle defect is associated with actual hypertrophy of the cricopharyngeal muscle in many cases.
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