{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:54:33Z","timestamp":1785887673248,"version":"3.56.0"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background and aims Cricopharyngeal bar-related dysphagia predominantly affects elderly patients with significant comorbidity, in whom surgical myotomy carries substantial risk. Cricopharyngeal per-oral endoscopic myotomy (C-POEM) is an endoscopic alternative; however, data in elderly populations remain limited. We evaluated the feasibility, safety, and efficacy of C-POEM in patients aged \u226570 years.<\/jats:p>\n                  <jats:p>Methods This prospective study included patients aged \u226570 years who underwent C-POEM between March 2023 and October 2025. Symptoms assessed using the Sydney Swallow Questionnaire (SSQ) at baseline, 4\u20136 weeks, and 3 months. Objective outcomes measured using EndoFLIP-derived distensibility index (DI) before C-POEM and 3 and 12 months post C-POEM. Technical success, clinical success, adverse events, and length of stay were recorded.<\/jats:p>\n                  <jats:p>Results Twelve patients (median age 79 years, interquartile range [IQR] 76.5\u201383.3; median Charlson Comorbidity Index 6, (IQR 5\u20137) underwent C-POEM. Technical success was 100%. Clinical success was observed in all patients at 3 months; sustained at 12-month follow-up. Median SSQ improved from 897 (IQR 686\u20131103) to 60 (IQR 20\u2013269; p = 0.001), and median UES DI improved from 1.6 (IQR 1.4\u20132.0) to 4.3 mm2\/mmHg (IQR 3.6\u20135.2; p = 0.001). Median length of stay was 3 days (IQR 2\u20134.5). No procedure-related major adverse events were observed. At a median follow-up of 55 weeks, symptomatic improvement was sustained.<\/jats:p>\n                  <jats:p>Conclusions In this elderly cohort, C-POEM was feasible, safe, and associated with significant symptomatic and physiological improvement. These findings support C-POEM as a promising option for cricopharyngeal bar-related dysphagia in elderly patients. Larger comparative studies are required to define its role relative to established therapies.<\/jats:p>","DOI":"10.1055\/a-2919-1389","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:45:13Z","timestamp":1784940313000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Feasibility, Safety, and Efficacy of Cricopharyngeal Per-oral Endoscopic Myotomy in Elderly Patients: A Prospective Single-center Study"],"prefix":"10.1055","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3881-4478","authenticated-orcid":false,"given":"Niroshan","family":"Muwanwella","sequence":"additional","affiliation":[{"name":"Royal Perth Hospital, Western Australia, Australia","place":["Perth"],"department":["Department of Gastroenterology"]},{"name":"Curtin University Curtin Medical School, Australia","place":["Bentley"],"department":["Curtin Medical School"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Chin","sequence":"additional","affiliation":[{"name":"Royal Perth Hospital, Western Australia, Australia","place":["Perth"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Law","sequence":"additional","affiliation":[{"name":"Royal Perth Hospital, Western Australia, Australia","place":["Perth"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiang","family":"Siah","sequence":"additional","affiliation":[{"name":"Royal Perth Hospital, Western Australia, Australia","place":["Perth"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jee","family":"Kong","sequence":"additional","affiliation":[{"name":"Royal Perth Hospital, Western Australia, Australia","place":["Perth"],"department":["Department of Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krish","family":"Ragunath","sequence":"additional","affiliation":[{"name":"Royal Perth Hospital, Western Australia, Australia","place":["Perth"],"department":["Department of Gastroenterology"]},{"name":"Curtin University Curtin Medical School, Australia","place":["Bentley"],"department":["Curtin Medical School"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1016\/0016-5085(90)91149-Z","article-title":"Biomechanics of cricopharyngeal bars","volume":"99","author":"R O Dantas","year":"1990","journal-title":"Gastroenterology"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1097\/MCG.0000000000000026","article-title":"Savary dilation is a safe and effective long-term means of treatment of symptomatic 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cricopharyngeal bar (C-POEM): a case series and video demonstration","volume":"37","author":"B Norton","year":"2024","journal-title":"Ann Gastroenterol"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1007\/s00455-014-9541-x","article-title":"The normative range for and age and gender effects on the Sydney swallow questionnaire (SSQ)","volume":"29","author":"M M Szczesniak","year":"2014","journal-title":"Dysphagia"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2147\/CIA.S97481","article-title":"Oropharyngeal dysphagia in older persons - from pathophysiology to adequate intervention: a review and summary of an international expert meeting","volume":"11","author":"R Wirth","year":"2016","journal-title":"Clin Interv Aging"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/S0016-5085(00)70137-5","article-title":"Development and validation of a self-report symptom inventory to assess the severity of oral-pharyngeal dysphagia","volume":"118","author":"K L Wallace","year":"2000","journal-title":"Gastroenterology"},{"issue":"05","key":"ref12","doi-asserted-by":"crossref","first-page":"e14766","DOI":"10.1111\/nmo.14766","article-title":"Development and validation of an electronic version of Sydney swallow questionnaire","volume":"36","author":"D Huang","year":"2024","journal-title":"Neurogastroenterol Motil"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/coa.12337","article-title":"Endoflip(R) evaluation of pharyngo-oesophageal segment tone and swallowing in a clinical population: a total laryngectomy case series","volume":"40","author":"J Regan","year":"2015","journal-title":"Clin Otolaryngol"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.1111\/nmo.12041","article-title":"New measures of upper esophageal sphincter distensibility and opening patterns during swallowing in healthy subjects using EndoFLIP(R)","volume":"25","author":"J Regan","year":"2013","journal-title":"Neurogastroenterol Motil"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.gtc.2020.04.002","article-title":"EndoFLIP in the Esophagus: assessing sphincter function, wall stiffness, and motility to guide treatment","volume":"49","author":"E N Donnan","year":"2020","journal-title":"Gastroenterol Clin N Am"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1007\/s00464-023-10512-0","article-title":"Outcomes after per-oral endoscopic myotomy for Zenker\u2019s diverticula (Z-POEM) and correlation with impedance planimetry (FLIP)","volume":"38","author":"S YW Che","year":"2024","journal-title":"Surg Endosc"}],"container-title":["Endoscopy International 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