Use of botulinum toxin for diagnosis and management of cricopharyngeal achalasia.

Cricopharyngeal achalasia produces dysphagia in many patients. The spasm has been treated in the past with medication, bouginage, pharyngeal plexus neurectomy, and cricopharyngeal myotomy. In some patients the cause of dysphagia may be elusive, or the patient may be a poor risk for a surgical intervention. We have found that cricopharyngeal muscle injections of botulinum toxin can be useful in the diagnosis and therapy of cricopharyngeal spasm.