Lateral pharyngeal outpouchings: A comparison of dysphagic and asymptomatic patients

Abstract

Abstract. Videofluoroscopic pharyngeal timings of individuals with dysphagia were compared with timings from individuals without dysphagia to determine if any abnormal pharyngeal movements were associated with dysphagia.Sixteen lateral pharyngeal outpouchings were seen in 50 dysphagic volunteers, whereas 71 were noted in 138 asymptomatic individuals. The outpouchings appeared just after oral delivery of the bolus into the pharynx after onset of the swallow at approximately 500 ms, as compared to the initial appearance during the mid-pharyngeal swallow at 750ms in asymptomatic individuals (P<0.01). The outpouchings disappeared during mid-pharyngeal swallow in symptomatic volunteers, at approximately 800 ms compared to disappearance during pharyngeal relaxation in asymptomatic volunteers at approximately 1100 ms (P<0.01). No other timing event was delayed nor event duration prolonged when the two groups were compared.This observation of earlier appearance followed by earlier disappearance of lateral pharyngeal outpouchings in dysphagic individuals may be caused by inner longitudinal pharyngeal muscles that are inhibited and then contract earlier than those seen in asymptomatic individuals. Outpouchings appearing later at the onset of pharyngeal contraction were not associated with dysphagia.

Lateral laryngopharyngeal diverticulum: anatomical and videofluoroscopic study

“…Lateral laryngopharyngeal protrusions classified as pouches and even as small diverticula may occur without symptoms [1,14]. There are descriptions of associated complaints with lateral laryngopharyngeal protrusions, classified as diverticula, like dysphagia [1], cervical aching and odynophagia [15], dysphagia and hoarseness [12], dysphagia, suffocation and cervical discomfort [14] and even the possibility of aspiration after swallowing [13,16].…”

“…There are descriptions of associated complaints with lateral laryngopharyngeal protrusions, classified as diverticula, like dysphagia [1], cervical aching and odynophagia [15], dysphagia and hoarseness [12], dysphagia, suffocation and cervical discomfort [14] and even the possibility of aspiration after swallowing [13,16]. Bagatzounis and Geyer [17] suggested that a lateral pharyngeal protrusion could be the cause of laryngeal superior nerve neuralgia.…”

Lateral laryngopharyngeal diverticula: a videofluoroscopic study of laryngopharyngeal wall in wind instrumentalists

“…These external cervical projections, which are associated with large diverticula, must be the cervical mass that had been mentioned previously (24) . These persons also mentioned the perception of cervical pressure, described as discomfort, associated with instrument use, as observed previously (9) . Acquired lateral laryngopharyngeal diverticula were identified in 100% of the musicians studied.…”

“…Without a clear dimension reference, absence of symptoms was previously considered to be common in cases of pharyngeal lateral diverticula (6,9,10) . In agreement with these previous observations, no spontaneous complaints were expressed by the 22 subjects all of them wind instrumentalists with large diverticula.…”

“…In agreement with these previous observations, no spontaneous complaints were expressed by the 22 subjects all of them wind instrumentalists with large diverticula. Nevertheless, there are descriptions of complaints associated with lateral laryngopharyngeal diverticula, such as dysphagia (10) , cervical aching and odynophagia (15) , dysphagia and hoarseness (11) , dysphagia, suffocation, and cervical discomfort (9) , aspiration after swallowing (16,28) , laryngeal superior nerve neuralgia (3) , cervical mass (24) , halitosis, and the sensation of a foreign body in the throat (18) . For this reason, all these complaints were directly mentioned to each volunteer, and all of them denied any such complaints.…”