Giant fibrovascular polyp of the hypopharynx: per-oral endoscopic removal

Abstract

Fibrovascular polyps occur most commonly in the cervical oesophagus, and are extremely rare in the hypopharynx. They can grow to a very large size over several years. We discuss the symptoms, diagnosis and surgical treatment techniques for upper aerodigestive tract fibrovascular polyps, in the light of the literature.

Large Fibrovascular Polyp of the Hypopharynx With Dysphonia: Direct Laryngoscopic Removal

“…One of them is called Killian space that is the region between the superior and inferior cricopharyngeal muscles and the other is so-called Laimer-Haeckermann space, that's the region between inferior cricopharyngeal muscle and proximal end of esophagus. These polyps are rarely originated from hypopharynx [1]. In our case, it was originated from the hypopharynx.…”

“…The symptoms of FVP change according to the size, location and composed complications. These masses may remain asymptomatic for a long time until they reach to the symptomatic form [1]. The most common symptoms are progressive dysphagia and feeling of mass [2,7].…”

“…Polyps are usually asymptomatic until they reach the size of recognized clinically [1]. The most common symptoms are difficulty swallowing and the feeling of foreign body.…”

Hypopharynx giant fibrovascular polyps

“…FVP of the esophagus are benign lesions that arise from the cervical esophagus and upper gastrointestinal esophageal sphincter [1]. The hypopharyngeal FVP usually originated from Killian dehiscence (the area between the superior and inferior cricopharyngeal muscles) or Laimer-Haeckermann area triangle (area between the inferior cricopharyngeal muscle and the proximal end of the esophagus) [2]. Due to weakness of muscles and the pressure during eating, loose mucosa prolapsed by gravity and elongate endoluminally from continuous peristaltic movements, leading to the mucosal and submucosal nodules valgus fold thickening and subsequent proliferative lesions [2,3].…”

“…The hypopharyngeal FVP usually originated from Killian dehiscence (the area between the superior and inferior cricopharyngeal muscles) or Laimer-Haeckermann area triangle (area between the inferior cricopharyngeal muscle and the proximal end of the esophagus) [2]. Due to weakness of muscles and the pressure during eating, loose mucosa prolapsed by gravity and elongate endoluminally from continuous peristaltic movements, leading to the mucosal and submucosal nodules valgus fold thickening and subsequent proliferative lesions [2,3]. Because of the dormant origination and the nature of slow growth [4], hypopharyngeal FVP is often asymptomatic and overlooked for years.…”