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What Is The Difference Between Cricopharyngeus Muscle, Pharynx And Larynx?
Question: Dear Doctor,
Could you please advise me the difference of cricopharyngeus, pharynx and larynx? I googled but got confused from the website information.
Basically, I'm confused about the differences of the illness of cricopharyngeal spasm, laryngeal spasm and pharyngeal spasm. Is there such illness of "pharyngeal spasm"? I really knows nothing about it and would appreciate if you can help me explain. Thanks a lot.
XXXX
Could you please advise me the difference of cricopharyngeus, pharynx and larynx? I googled but got confused from the website information.
Basically, I'm confused about the differences of the illness of cricopharyngeal spasm, laryngeal spasm and pharyngeal spasm. Is there such illness of "pharyngeal spasm"? I really knows nothing about it and would appreciate if you can help me explain. Thanks a lot.
XXXX
Brief Answer:
Spasm can happen only in the cricopharynx and upper part of larynx
Detailed Answer:
Hi
Thanks for posting the query
Pharynx is a hollow space starting from the back of the nose continuing down upto the level of the vocal cords (voice box).
Larynx is a space starting from the level of the vocal cords (voice box) to the level of first division of the bronchus (the respiratory tube connecting first part of the lower airway and the lungs).
Cricopharynx is the entrance of the esophagus (food pipe).
To make it much more simple, if you look from the left side of the head, the pharynx, larynx and cricopharynx are situated in the shape of ‘L’. The first part or the vertical part of the ‘L’ denotes pharynx, the angle between the vertical and horizontal part is the larynx and horizontal part of the ‘L’ is the cricopharynx. Vocal cords (voice box) separates the larynx from the pharynx and the cricopharynx.
The Larynx is the entry into the wind pipe and the cricopharynx is the entry into the food pipe.
The spasm usually occurs either in the larynx or in the cricopharynx but not in the pharynx. The pharynx is a wider space compared to the larynx and the cricopharynx, hence, the spasm is not much appreciated.
Spasm in the larynx happen at the level of vocal cords (voice box) and not lower down. The entire food pipe is a muscular tube starting from the cricopharynx to the upper level of the stomach and spasms can happen anywhere in the tube.
Hope this answers your query. Revert back to me if you have any follow up queries.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Spasm can happen only in the cricopharynx and upper part of larynx
Detailed Answer:
Hi
Thanks for posting the query
Pharynx is a hollow space starting from the back of the nose continuing down upto the level of the vocal cords (voice box).
Larynx is a space starting from the level of the vocal cords (voice box) to the level of first division of the bronchus (the respiratory tube connecting first part of the lower airway and the lungs).
Cricopharynx is the entrance of the esophagus (food pipe).
To make it much more simple, if you look from the left side of the head, the pharynx, larynx and cricopharynx are situated in the shape of ‘L’. The first part or the vertical part of the ‘L’ denotes pharynx, the angle between the vertical and horizontal part is the larynx and horizontal part of the ‘L’ is the cricopharynx. Vocal cords (voice box) separates the larynx from the pharynx and the cricopharynx.
The Larynx is the entry into the wind pipe and the cricopharynx is the entry into the food pipe.
The spasm usually occurs either in the larynx or in the cricopharynx but not in the pharynx. The pharynx is a wider space compared to the larynx and the cricopharynx, hence, the spasm is not much appreciated.
Spasm in the larynx happen at the level of vocal cords (voice box) and not lower down. The entire food pipe is a muscular tube starting from the cricopharynx to the upper level of the stomach and spasms can happen anywhere in the tube.
Hope this answers your query. Revert back to me if you have any follow up queries.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Dr. XXXXXXX
Thanks a lot for your explanation that is very clear and helpful to me.
May I ask you how to diagnose cricopharyngeal spasm and laryngeal spasm?
As far as I know, laryngoscope can't see cricopharynx and diagnose cricopharyngeal spasm. Will a barium swallow be able to diagnose cricopharyngeal spasm?
As for laryngeal spasm, can it be diagnosed by laryngoscope?
Besides, what are the treatments for cricopharyngeal spasm and laryngeal spasm?
I've uploaded a doc named "summary written by patient 0000". Could you please have a look of my situation and give me some input and advice?
BTW, I live in XXXX.
Sincere thanks & I look forward to your reply.
XXXX
Thanks a lot for your explanation that is very clear and helpful to me.
May I ask you how to diagnose cricopharyngeal spasm and laryngeal spasm?
As far as I know, laryngoscope can't see cricopharynx and diagnose cricopharyngeal spasm. Will a barium swallow be able to diagnose cricopharyngeal spasm?
As for laryngeal spasm, can it be diagnosed by laryngoscope?
Besides, what are the treatments for cricopharyngeal spasm and laryngeal spasm?
I've uploaded a doc named "summary written by patient 0000". Could you please have a look of my situation and give me some input and advice?
BTW, I live in XXXX.
Sincere thanks & I look forward to your reply.
XXXX
Brief Answer:
Cricopharyngeal spasm is identified by the traditional VFSS
Detailed Answer:
Hi,
Thanks for writing back.
1. Cricopharyngeal spasm is identified by the traditional ‘Video fluoroscopic swallowing study’ (VFSS), whereas Laryngeal spasm is identified by ‘Direct Laryngoscopy’.
2. Yes, the Barium swallow can also help in identifying the cricopharyngeal spasm.
3. Cricopharyngeal spasm requires psychotherapy, breathing and relaxation exercises. Medicines such as anxiolytics are very useful. Laryngeal spasm which is not life-threatening is usually treated with the proton pump inhibitors and breathing-related exercises. Laryngeal spasms which are life-threatening demands immediate intervention by the medics.
4. I have gone through your report thoroughly and understood your problem. You seem to be suffering from ‘Laryngopharygeal Reflux’. The clinching point was the relief in the symptoms with anxiolytics and proton pump inhibitors.
I would suggest you drink frequent sips of warm water. Take frequent small meals. Avoid chilled food and beverages, fizzy drinks, coffee, and stress. Try breathing and relaxation exercises. Yoga would be ideal for you. Continue with the medicines you are taking.
Avoid concentrating on this problem; the more you try to think about it, the worse it becomes.
Hope this clarifies your doubts. Wish you good health.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Cricopharyngeal spasm is identified by the traditional VFSS
Detailed Answer:
Hi,
Thanks for writing back.
1. Cricopharyngeal spasm is identified by the traditional ‘Video fluoroscopic swallowing study’ (VFSS), whereas Laryngeal spasm is identified by ‘Direct Laryngoscopy’.
2. Yes, the Barium swallow can also help in identifying the cricopharyngeal spasm.
3. Cricopharyngeal spasm requires psychotherapy, breathing and relaxation exercises. Medicines such as anxiolytics are very useful. Laryngeal spasm which is not life-threatening is usually treated with the proton pump inhibitors and breathing-related exercises. Laryngeal spasms which are life-threatening demands immediate intervention by the medics.
4. I have gone through your report thoroughly and understood your problem. You seem to be suffering from ‘Laryngopharygeal Reflux’. The clinching point was the relief in the symptoms with anxiolytics and proton pump inhibitors.
I would suggest you drink frequent sips of warm water. Take frequent small meals. Avoid chilled food and beverages, fizzy drinks, coffee, and stress. Try breathing and relaxation exercises. Yoga would be ideal for you. Continue with the medicines you are taking.
Avoid concentrating on this problem; the more you try to think about it, the worse it becomes.
Hope this clarifies your doubts. Wish you good health.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Dear Dr. XXXXXXX
Thanks a lot for your reply.
Just want to share with you some communication I had with a professor whose research area is Swallowing Rehabilitation: In addition to tests that allow the clinician to see things through a scope, there are tests in which we can watch a swallow take place, or in which we can measure pressures that are generated along the tube. An x-ray is needed to watch the swallow. X-rays of the pharynx are called “modified barium swallows” or “videofluoroscopy” while x-rays of the esophagus are called “upper GI series” or “barium swallows”. These tests are particularly helpful for understanding whether food gets stuck which we determine by using barium foods and liquids and watching them travel through the tubes of the throat and esophagus. Pressure tests are called “manometry” and involve a catheter being inserted (similar to a scope) with pressure sensors along its length that can determine whether the muscles that line the tubes are working to generate pressure appropriately to squeeze food down. This includes appropriate relaxation at certain times and contraction at other times.
Besides, I do agree that the stomach flu I had 2 years ago triggered Laryngeal Pharyngeal Reflux(LPR) that needs different treatment than typical GERD. That is the reason why I took double dosage PPI for months since Oct 2017. Kindly pls find the link of an article about LPR here that I find helpful:
https://aboutgerd.org/laryngeal-pharyngeal-reflux.html
I do think I need to do a barium swallow to get correct diagnosis and see the right ENT doctor to get proper treatment. I've been mislead and getting lost ever since the recurrence of my illness two years ago. Hopefully I'm now on the right track.
You've given quite some input and please accept my sincere thanks.
All the best,
XXXX
Thanks a lot for your reply.
Just want to share with you some communication I had with a professor whose research area is Swallowing Rehabilitation: In addition to tests that allow the clinician to see things through a scope, there are tests in which we can watch a swallow take place, or in which we can measure pressures that are generated along the tube. An x-ray is needed to watch the swallow. X-rays of the pharynx are called “modified barium swallows” or “videofluoroscopy” while x-rays of the esophagus are called “upper GI series” or “barium swallows”. These tests are particularly helpful for understanding whether food gets stuck which we determine by using barium foods and liquids and watching them travel through the tubes of the throat and esophagus. Pressure tests are called “manometry” and involve a catheter being inserted (similar to a scope) with pressure sensors along its length that can determine whether the muscles that line the tubes are working to generate pressure appropriately to squeeze food down. This includes appropriate relaxation at certain times and contraction at other times.
Besides, I do agree that the stomach flu I had 2 years ago triggered Laryngeal Pharyngeal Reflux(LPR) that needs different treatment than typical GERD. That is the reason why I took double dosage PPI for months since Oct 2017. Kindly pls find the link of an article about LPR here that I find helpful:
https://aboutgerd.org/laryngeal-pharyngeal-reflux.html
I do think I need to do a barium swallow to get correct diagnosis and see the right ENT doctor to get proper treatment. I've been mislead and getting lost ever since the recurrence of my illness two years ago. Hopefully I'm now on the right track.
You've given quite some input and please accept my sincere thanks.
All the best,
XXXX
Brief Answer:
'Videofluoroscopic Swallowing Study' is the Gold Standard investigation...
Detailed Answer:
Hi
Welcome back
My sincere thanks for sharing this valuable information.
1. Yes, you are absolutely right. As I had discussed with you in my earlier response, 'Videofluoroscopic Swallowing Study' is the Gold Standard investigation in Cricopharyngeal Spasm. Manometric studies may not prove to be much beneficial as many patients will not have a problem while swallowing and the pressure changes at the level of Cricopharynx is very subtle, which can give false negative results.
2. I strongly feel that we need to address the Laryngopharyngeal reflux efficiently in order to get a complete recovery. A good Gastroenterologist will definitely help you in getting out of this problem.
I wish you good health. God bless you.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
'Videofluoroscopic Swallowing Study' is the Gold Standard investigation...
Detailed Answer:
Hi
Welcome back
My sincere thanks for sharing this valuable information.
1. Yes, you are absolutely right. As I had discussed with you in my earlier response, 'Videofluoroscopic Swallowing Study' is the Gold Standard investigation in Cricopharyngeal Spasm. Manometric studies may not prove to be much beneficial as many patients will not have a problem while swallowing and the pressure changes at the level of Cricopharynx is very subtle, which can give false negative results.
2. I strongly feel that we need to address the Laryngopharyngeal reflux efficiently in order to get a complete recovery. A good Gastroenterologist will definitely help you in getting out of this problem.
I wish you good health. God bless you.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
Dr. Naveen Kumar Nanjasetty
Otolaryngologist / ENT Specialist
Practicing since :2001
Answered : 2540 Questions
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