Cricopharyngeal bar

Last revised by Mohammadtaghi Niknejad on 20 Jul 2022

Cricopharyngeal bar refers to the radiographic appearance of a prominent cricopharyngeus muscle contour on barium swallow.

The terms cricopharyngeal bar and cricopharyngeal muscle spasm/achalasia are often used synonymously but this is incorrect because studies have demonstrated that presence of a cricopharyngeal bar is not always related to cricopharyngeus spasm but can be due to other pathologies 4

Present in up to 20% of barium studies 1

Mostly asymptomatic and found as an incidental finding on barium swallow. One-third of patients may complain of dysphagia but a cricopharyngeal bar is rarely a cause 1,5

Causes include 1,2:

  • idiopathic (i.e. normal variant)
  • cricopharyngeal muscle spasm/achalasia (i.e. failed relaxation)
  • cricopharyngeus muscle hypertrophy and/or fibrosis

On barium swallow lateral projection:

  • smooth posterior indentation of the esophagus at the level of C5-C6

In selected patients with no other cause for dysphagia demonstrated, cricopharyngeal bars can be treated with a myotomy, esophageal dilatation and/or botulinum toxin injection 5,6.

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3
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