Post-laryngectomy neopharyngeal diverticulae

Hartley, Chris; Saeed, Shakeel R; Farrington, W. T.

doi:10.1017/s002221510012715x

Cited by 10 publications

(23 citation statements)

References 10 publications

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“…In assessing the quality of speech, the reconstructed PE segment should be examined dynamically. 24 However, these structures do not interfere with alaryngeal speech proficiency. Patients with functional tracheoesophageal speech showed a regular-vibrating PE segment during phonation.…”

Section: Discussionmentioning

confidence: 99%

Cineradiography of the Pharyngoesophageal Segment in Postlaryngectomy Patients

Weissenbruch¹,

Kunnen²,

Albers

et al. 2000

Ann Otol Rhinol Laryngol

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The use of tracheoesophageal voice prostheses has gained wide acceptance in the field of vocal rehabilitation after total laryngectomy. In a randomized study with 3 arms, alaryngeal speech proficiency was assessed in 60 postlaryngectomy patients: 20 patients underwent primary unilateral pharyngeal myotomy, 21 patients underwent neurectomy of the pharyngeal plexus in addition to pharyngeal myotomy, and 19 patients did not undergo an additional surgical procedure. Pharyngoesophageal (PE) dynamics were examined during esophageal and tracheoesophageal speech. A single vibrating PE segment was seen in good alaryngeal speakers. Hypertonicity, spasm, strictures, and hypotonicity of the PE segment were correlated significantly with poor or moderate alaryngeal speech. Unilateral myotomy with or without unilateral neurectomy prevented hypertonicity or spasm of the PE segment. The acquisition of alaryngeal speech did not differ significantly between the 2 groups who had undergone an additional surgical procedure. Evaluation of anatomic and physiological factors may be helpful in subsequent clinical management to achieve effective alaryngeal speech.

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Section: Discussionmentioning

confidence: 99%

Cineradiography of the Pharyngoesophageal Segment in Postlaryngectomy Patients

Weissenbruch¹,

Kunnen²,

Albers

et al. 2000

Ann Otol Rhinol Laryngol

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“…[1][2][3][4] In 1962, Kirchner and Scatliff 1 reported on anterior pharyngeal pouches and suggested the term ''pseudo-diverticulum.'' Hartley et al 5 used the term ''pseudo-epiglottis'' because of the resemblance of the posterior wall of the anterior pharyngeal pouch to the epiglottis on a barium swallow. However, the word ''epiglottis'' refers to a dynamic functional ''organ.''…”

Section: Discussionmentioning

confidence: 99%

Laser treatment of symptomatic anterior pharyngeal pouches after laryngectomy

1999

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“…Another article described 9 patients treated with CO 2 laser division of their neo-vallecula, reporting 8 of the 9 had “obvious improvement” in swallowing, with 7 patients additionally noting less food regurgitation and 5 noting less food accumulation [ 2 ] ( Table 1 ). A third article used a CO 2 laser in 4 patients, all with clinical resolution of symptoms and 2 with preoperative and postoperative swallow studies objectively demonstrating improvement [ 12 ] ( Table 1 ). Overall, laser appears to have positive swallowing outcomes in this patient population.…”

Section: Discussionmentioning

confidence: 99%

CO2 Laser Division of Neo-Vallecula Improves Dysphagia in the Postlaryngectomy Patient: A Case Series and Review of the Literature

Saltagi

Wallace

Mantravadi

et al. 2020

Case Reports in Otolaryngology

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Objectives. To review the literature on neo-vallecula diagnosis and management and to report our findings regarding 3 patients who developed neo-vallecula in the context of free-flap pharyngeal reconstruction following total laryngectomy. Methods. This case series reports three patients who developed a neo-vallecula following a laryngectomy and free-flap pharyngeal reconstruction. All three patients were treated with a CO2 laser endoscopic procedure. Results. Neo-vallecula formation is thought to be related to tension on the neopharyngeal closure or closure technique following total laryngectomy. Diagnosis may be obtained with swallow studies, videofluoroscopy, or endoscopy. Treatment has included external excision and endoscopic procedures such as stapling, harmonic scalpel excision, and laser removal. We utilized an endoscopic approach entailing the use of a CO2 laser to divide the neo-vallecula, and all our patients reported improvement in their dysphagia. Conclusions. Treatment of an anterior neo-vallecula endoscopically using a CO2 laser is an effective way to treat dysphagia in patients following total laryngectomy with free-flap pharyngeal reconstruction.

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Post-laryngectomy neopharyngeal diverticulae

Abstract: Four cases with a neopharyngeal diverticulum following total laryngectomy are presented. Each patient required surgery for complications directly related to the pouch. The relevance of these diverticulae is discussed with reference to their aetiology, complications and management.

Cited by 10 publications

References 10 publications

Cineradiography of the Pharyngoesophageal Segment in Postlaryngectomy Patients

Cineradiography of the Pharyngoesophageal Segment in Postlaryngectomy Patients

Laser treatment of symptomatic anterior pharyngeal pouches after laryngectomy

CO2 Laser Division of Neo-Vallecula Improves Dysphagia in the Postlaryngectomy Patient: A Case Series and Review of the Literature

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