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The Upper Esophageal Sphincter: Anatomy and Physiology

Ramaswamy, Apoorva ; Martell, Per LU orcid ; Azevedo, Renata and Belafsky, Peter (2022) In Annals of Esophagus 5.
Abstract
The upper esophageal sphincter (UES), also known as the pharyngoesophageal segment (PES), is a 4-cm segment of the digestive tract that separates the esophagus from the pharynx and larynx. This narrative review represents an overview of the anatomy and physiology of this critical component of the airway protective mechanism. The structure is bounded anteriorly by the larynx, posterolaterally by the pharyngoesophageal muscles, superiorly by the pharynx and inferiorly by the esophagus. Guarding the entrance of the esophagus, the UES controls inflow and outflow through the region, preventing aerophagia in the anterograde direction as well as regurgitation in the retrograde. Although the cricopharyngeus muscle (CPM) is often considered... (More)
The upper esophageal sphincter (UES), also known as the pharyngoesophageal segment (PES), is a 4-cm segment of the digestive tract that separates the esophagus from the pharynx and larynx. This narrative review represents an overview of the anatomy and physiology of this critical component of the airway protective mechanism. The structure is bounded anteriorly by the larynx, posterolaterally by the pharyngoesophageal muscles, superiorly by the pharynx and inferiorly by the esophagus. Guarding the entrance of the esophagus, the UES controls inflow and outflow through the region, preventing aerophagia in the anterograde direction as well as regurgitation in the retrograde. Although the cricopharyngeus muscle (CPM) is often considered synonymous with the UES, in reality it is but one component of the complicated anatomy. In fact, relaxation of the CPM is not the primary contributor to UES opening. During the act of swallow, the relaxation of the CPM, elevation of the larynx and propulsion of the food bolus by the pharynx coordinate to open the UES and facilitate deglutition. An understanding of the anatomy of the region in addition to the phases of UES opening facilitates more refined therapeutic interventions for patients with pharyngoesophageal swallow impairment and dysphagia. (Less)
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author
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publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Esophagus
volume
5
publisher
AME Publishing Company
external identifiers
  • scopus:85133227655
ISSN
2616-2784
language
English
LU publication?
no
id
17429489-4cc9-4293-a850-9fbc66175a01
alternative location
https://aoe.amegroups.org/article/view/6432/html
date added to LUP
2024-12-27 13:29:12
date last changed
2025-04-04 13:52:10
@article{17429489-4cc9-4293-a850-9fbc66175a01,
  abstract     = {{The upper esophageal sphincter (UES), also known as the pharyngoesophageal segment (PES), is a 4-cm segment of the digestive tract that separates the esophagus from the pharynx and larynx. This narrative review represents an overview of the anatomy and physiology of this critical component of the airway protective mechanism. The structure is bounded anteriorly by the larynx, posterolaterally by the pharyngoesophageal muscles, superiorly by the pharynx and inferiorly by the esophagus. Guarding the entrance of the esophagus, the UES controls inflow and outflow through the region, preventing aerophagia in the anterograde direction as well as regurgitation in the retrograde. Although the cricopharyngeus muscle (CPM) is often considered synonymous with the UES, in reality it is but one component of the complicated anatomy. In fact, relaxation of the CPM is not the primary contributor to UES opening. During the act of swallow, the relaxation of the CPM, elevation of the larynx and propulsion of the food bolus by the pharynx coordinate to open the UES and facilitate deglutition. An understanding of the anatomy of the region in addition to the phases of UES opening facilitates more refined therapeutic interventions for patients with pharyngoesophageal swallow impairment and dysphagia.}},
  author       = {{Ramaswamy, Apoorva and Martell, Per and Azevedo, Renata and Belafsky, Peter}},
  issn         = {{2616-2784}},
  language     = {{eng}},
  month        = {{09}},
  publisher    = {{AME Publishing Company}},
  series       = {{Annals of Esophagus}},
  title        = {{The Upper Esophageal Sphincter: Anatomy and Physiology}},
  url          = {{https://aoe.amegroups.org/article/view/6432/html}},
  volume       = {{5}},
  year         = {{2022}},
}