Lateral laryngopharyngeal diverticulum: anatomical and videofluoroscopic study

Costa, Milton Melcı́ades Barbosa; Koch, Hilton Augusto

doi:10.1007/s00330-005-2687-z

Cited by 12 publications

(34 citation statements)

References 17 publications

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“…These diverticula are considered to result from pharyngeal overpressure, which is often produced by dysphagia (4,5,7) . Their presence in the PD patients indicates a long-term pharyngeal pressure overcharge.…”

Section: Discussionmentioning

confidence: 99%

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Dysphagia and Sialorrhea:

Nicaretta¹,

Rosso

Mattos

et al. 2013

Arq. Gastroenterol.

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-Context -Dysphagia and sialorrhea in patients with Parkinson's disease are both automatically accepted as dependent on this neurological disease. Objective -The aim were to establish if these two complaints are a consequence or associated manifestations of Parkinson's disease. Method -Two Parkinson's diseases groups from the same outpatients' population were studied. Patients in the first group, with dysphagia, were studied by videofluoroscopy. The second, with sialorrhea, were studied by the scintigraphic method, Results -Videofluoroscopic examination of the oral, pharyngeal and esophageal phases of swallowing showed that 94% of Parkinson's diseases patients present, structural causes, not related to Parkinson's diseases, able to produce or intensify the observed disphagia. The scintigraphic examination of Parkinson's diseases patients with sialorrhea showed that there is no increase of serous saliva production. Nevertheless, showed a significantly higher velocity of saliva excretion in the Parkinson's diseases patients.Conclusions -Dysphagia can be due to the muscular rigidity often present in the Parkinson's diseases patient, or more usually by non Parkinson's disease associated causes. In Parkinson's diseases patients, sialorrhea is produced by saliva retention. Nevertheless, sialorrhea can produce discomfort in swallowing, although without a formal complaint of dysphagia. In this case, subclinical dysphagia must be considered. Sialorrhea is indicative of dysphagia or at least of subclinical dysphagia. As final conclusion, Parkinson's diseases can be an isolated cause of dysphagia and/or sialorrhea, but frequently, a factor unrelated to Parkinson's diseases is the main cause of or at least aggravates the dysphagia.

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Section: Discussionmentioning

confidence: 99%

“…Their presence in the PD patients indicates a long-term pharyngeal pressure overcharge. These kind of diverticula usually do not present symptoms (4,5,7) .…”

Section: Discussionmentioning

confidence: 99%

Dysphagia and Sialorrhea:

Nicaretta¹,

Rosso

Mattos

et al. 2013

Arq. Gastroenterol.

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“…They are considered to be 4 times more frequent than Killian-Jamiesen diverticula (19) . However, the lateral laryngopharyngeal protrusions are at least 9 times more frequent than the Zenker type (6) . Lateral laryngopharyngeal diverticula are small pathological sacs that appear as "ears", projecting at the level of the vallecula, and are usually bilateral.…”

Section: Introductionmentioning

confidence: 93%

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

Costa

Alvite

2012

Arq. Gastroenterol.

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CONTEXT: This paper analyze healthy musicians who play wind instruments. OBJECTIVE: To identify possible diverticular formations on the laryngopharyngeal wall produced by pharyngeal overpressure during the use of these instruments. METHODS: Through a videofluoroscopic method, 22 professional musicians had their pharynx analyzed in frontal face and profile, by swallowing 20 mL of barium sulfate solution and blowing against resistance. RESULTS: All the volunteers showed lateral laryngopharyngeal diverticula (3 unilateral and 19 bilateral) with areas ranging from 0.7 to 6 cm². Trumpet and clarinet players showed larger diverticula, on both the right and left sides. Any important complaints were noted spontaneously or after questions. In the barium-swallow analyses, the 41 diverticula previously identified in the blowing tests were not seen or appeared to be smaller, because of the free flux passage from the pharynx to the esophagus. Despite the existence of the other, less resistant areas on the laryngopharyngeal segment, no other protrusions could be found in this group of wind instrumentalists. CONCLUSIONS: The lateral laryngopharyngeal diverticula that occur in blow instrumentalists is distinct of diverticula produced by laryngopharyngeal overpressure determined by abnormally high resistance to flux passage from pharynx to esophagus. In musicians is the persistent and continuous pharyngeal overpressure induced by the resistance of the instrument's mouthpiece will strongly distend the anatomically less resistant areas of the pharynx, producing a large protrusion. Laryngopharyngeal overpressure without abnormal resistance to flux passage explain the way blow instrumentalists protrusions did not appear as full sacs in a barium-swallow test, despite their larger dimensions. As final conclusion the musician-acquired diverticula must be considered as an "occupational overuse syndrome".

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“…LFD'lerin yaşamsal komplikasyonu yutma sonrası pulmoner aspirasyondur. [5][6][7] Kraniyo-kaudal çapına göre LFD'ler 3 evrede değerlendirilir: 5 mm'den küçükse evre I, 5-10 mm ise evre II, 10 mm'den büyük ise evre III olarak gruplandırılırlar. Lindbichler ve ark., yaptıkları çalışmada, evre III LFD'lerde aspirasyon riskini %56 bulmuştur.…”

Section: Radiologyunclassified

“…Bu nedenle videofloroskopi gibi fonksiyonel görüntüleme teknikleri ile görüntü-lenmediklerinde, rutin faringo-özefagografik incelemelerde rahatlıkla gözden kaçabilirler. 5,7 Bizim olgumuzda da LFD, videofloroskopik yön-temle yapılan baryumlu faringo-özefagografi incelemesinde vallekula düzeyinde sağ lateral uzanımı olan bir dolum fazlalığı şeklinde gözlendi. Yutkunma ile dolum fazlalığının gerilediği ve kıs-men kaybolduğu görüldü.…”

Section: Radiologyunclassified