Which of the following statements about UES dysfunction are correct?

B. Typical symptoms include cervical dysphagia, expectoration of saliva, and hoarseness.

C. The classic finding on barium esophagogram is a posterior cricopharyngeal bar.

D. Medical or surgical therapy of gastroesophageal reflux may be curative.

DISCUSSION: The unique anatomic characteristics of the UES and the limitations of existing equipment in recording the rapid sequence of events associated with swallowing make standard manometric definition of UES motor abnormalities extremely difficult. Characteristic consistent abnormalities of UES function in patients with cricopharyngeal dysfunction have not been well documented. UES dysfunction results in cervical dysphagia, expectoration of saliva that is no longer swallowed freely, and, often, intermittent hoarseness due to alteration of the larynx and vocal cords by the pull of the abnormal cricopharyngeal sphincter. Barium esophagography in the patient with UES dysfunction frequently shows a posterior cricopharyngeal “bar,” representing the prominent impression of the sphincter on the esophageal lumen. Patients with gastroesophageal reflux may present with cervical dysphagia due to secondary UES dysfunction. Successful medical or surgical treatment of the reflux may eliminate the cervical complaints. Since the UES is normally 3 to 5 cm. long, when a cervical esophagomyotomy is required for treatment of cricopharyngeal dysfunction, a generous myotomy, 7 to 10 cm. long, is carried out to ensure complete division of all incoordinated UES muscle fibers.