The upper oesophageal sphincter
Abstract
Abstract The upper oesophageal sphincter (UOS) is a high‐pressure zone comprising functional activity of three adjacent muscles together with cartilage and connective tissue. Its primary function is to allow food into the oesophagus and prevent air ingestion. However, it must also allow the reflux of material during belching or vomiting. Cricopharyngeus is the most important muscle with contributions from inferior pharyngeal constrictor and cervical oesophagus. Basal tone within the UOS is contributed to by all three muscles with asymmetry in the axial plane. Relaxation of the UOS occurs during swallowing as well as in sleep while UOS pressure rises with stress, slow oesophageal distension, intra‐oesophageal acid infusion and pharyngeal stimulation with air or water. Many physiological characteristics have been attributed to UOS function following videofluoroscopic swallow examinations, manometry and electromyography but a range of normal values remains controversial and their utility uncertain. The result has been that pathological change is inconsistently characterized and management is instigated without a satisfactory evidence base. In this article, we review the anatomy, physiology and pathophysiology of the UOS along with the current opinions on investigation and treatment of UOS dysfunction.
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VFSS uses ionizing radiation, is unavailable or undesirable for many patients, is relatively expensive, and requires specialized instrumentation and trained clinicians, leaving many patients undiagnosed or inaccurately diagnosed and at ongoing risk of dysphagia-related complications.
“However, VFSSs, which use ionizing radiation to produce radiographic images with full temporal resolution, are unavailable or undesirable to many patients, are relatively expensive, and require specialized instrumentation and trained clinicians to perform and interpret, leaving many patients undiagnosed or inaccurately diagnosed, and exposed to ongoing risk of dysphagia-related complications [19].”
From Upper esophageal sphincter opening segmentation with convolutional recurrent neural networks in high resolution cervical auscultation (2021) · cites this paper as [19]
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Pharyngeal (Zenker's) diverticulum is a disorder of upper esophageal sphincter opening
Cook, I. J., Gabb, M., Panagopoulos, V., Jamieson, G. G., Dodds, W. J., Dent, J., & Shearman, D. J. (1992) · Gastroenterology · doi:10.1016/0016-5085(92)91508-2 · Cited by 342 · see citing works
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Hao (2015) · doi:10.1002/14651858 · Cited by 11,321 · see citing works
Khalifa, Y., Donohue, C., Coyle, J. L., & Sejdic, E. (2021) · IEEE Journal of Biomedical and Health Informatics · doi:10.1109/jbhi.2020.3000057 · Cited by 49 · see citing works
Assessing Upper Esophageal Sphincter Function in Clinical Practice: a Primer
Ahuja, N. K., & Chan, W. W. (2016) · Current Gastroenterology Reports · doi:10.1007/s11894-015-0480-y · Cited by 22 · see citing works
- Authors
- Singh, S., & Hamdy, S.
- Corresponding author
- Hamdy, S.
- Venue
- Neurogastroenterology & Motility
- Publisher
- Wiley
- Published
- 2005-04-18
- Volume
- 17
- Issue
- s1
- Pages
- 3-12
- ISSN
- 1350-1925 (ISSN-L)
- 1365-2982
- OpenAlex
- W2135765357
- Cited by
- 80
- References
- 1
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2023: 7 · 2022: 9 · 2021: 7 · 2020: 7 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 4 · 2014: 2 · 2013: 4 · 2012: 5
- FWCI
- 0.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurogastroenterology & Motility (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Surgery › Esophageal and GI Pathology
- Keywords
- upper esophageal sphincter, cricopharyngeus muscle, basal tone, pharyngeal stimulation, videofluoroscopic swallowing study, manometry, electromyography, oesophageal reflux, air ingestion
- MeSH terms
- Humans, Esophageal Sphincter, Upper
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