Anteriores Pseudodivertikel nach Laryngektomie

Abstract

An anterior neopharyngeal pseudodiverticulum is a mucosal pouch located between the tongue and hypopharynx due to an epiglottis-like posterior tissue band that forms after total laryngectomy. This condition has rarely been mentioned in literature. Incidence, symptoms, treatment, and possible etiologic factors were examined. Twenty post-laryngectomy patients were questioned about swallowing disorders and were examined clinically and by barium swallow. Eleven patients were found to have a pseudodiverticulum, of which 9 patients suffered from dysphagia. We found no correlation between the formation of a pseudodiverticulum and radiotherapy or post-laryngectomy complications. All symptomatic patients were treated by dissecting the posterior tissue band endoscopically with a CO2-laser, bringing complete relief of symptoms in 8 of 9 patients. Our study showed that the anterior pseudodiverticulum can be a frequent cause of dysphagia after laryngectomy. It can easily be diagnosed clinically and radiologically. Endoscopic treatment with a CO2-laser is simple and effective.

Swallowing outcomes following division of pseudo‐epiglottis resulting from vertical pharyngeal closure in laryngectomy

“…Further studies have confirmed these findings. 8,21 Fistula formation has also been disproved as a cause of pseudo-epiglottis. 2,6,22,23 Dysphagia after laryngectomy is a common problem, varying from 10% to 60%.…”

“…[6][7][8] In addition to the above, dysphagia outcomes following surgical repair of pseudo-epiglottis utilizing the carbon dioxide (CO 2 ) laser have only been reported in three studies to date, again without the use of pre-and post-operative measurements of dysphagia using a validated questionnaire. [6][7][8] Oursin et al and Pitzer et al reported complete resolution of dysphagia after pseudo-epiglottis division in 88% of their patients, 6,8 while 100% improvement in dysphagia post-operatively was noted in all three patients in a case series article. 7 Dysphagia following laryngectomy is common and multifactorial in etiology, with an incidence ranging from 10% to 60%.…”

“…This has not been quantified in the available studies prior to pseudo-epiglottis division, perhaps due to the small number of included patients, ranging from 3 to 9. [6][7][8] In our institution, we encountered several post-laryngectomy patients with pseudo-epiglottis formation, as the senior author (MAB) had elected to close the pharynx in a vertical fashion using a Cushing-type continuous suture. Vertical closure is associated with a reduced potential for pharyngo-cutaneous fistula formation.…”

European white paper: oropharyngeal dysphagia in head and neck cancer

“…The body of literature on treatment effects of OD after TLE remains poor and there is no consensus on the diagnosis and treatment of OD for this population [434]. Some studies showed preliminary promising results of botulinum toxin injections, endoscopic dilatations, and TOLS [441][442][443][444][445][446][447][448]. However, significant treatment effects or trends of these techniques were not found.…”

Módosított Weerda-laringoszkópok alkalmazási területei a fül-orr-gégészeti gyakorlatban

“…Jól vizualizálható retrocricoid régió bal oldali endoszkópos arytenoid abdukciós lateropexia közben. 1) Bal oldali kannaporc, 2) retrocricoid terület, 3) hátsó garatfal, *: endolaryngealis fonalvezető eszköz ÖSSZEFOGLALÓ KÖZLEMÉNY diverticulum eltávolítása laryngectomiát követően, nyelőcsőpolip eltávolítása, gégeplasztika, idegentest-eltávolítás vagy a cricopharyngealis izom endoszkópos myotomiája [13][14][15][16][17][18][19]. A feltáró fő előnye, hogy mérete egyénileg állítható még a behelyezés után is.…”