Unusual Pharyngeal Lesion Causing Dysphagia

Abstract

A 58-year-old man was evaluated for a 42-year complaint of a pharyngeal foreign body sensation whenever he ate. Examination revealed normal anatomy at rest but diffuse hypopharyngeal distension with Valsalva's maneuver. His past history was remarkable for an infectious illness, possibly diphtheria. We speculate that this unusual case most likely represents a postdiphtheritic selective pharyngeal paralysis and present his case, radiographic findings, and a discussion of the differential diagnosis.

Pharyngoceles: A photo‐anatomic study and novel management

“…[3][4][5][6][7][8][9][10][11][12][13][14][15] Other authors suggest that this anomaly may represent a third or fourth branchial cleft anomaly. Most authors posit that increased intraluminal pressure causes inherent weak areas of the pharynx, the areas between the overlapping constrictor muscles, to bulge outward.…”

“…Most authors posit that increased intraluminal pressure causes inherent weak areas of the pharynx, the areas between the overlapping constrictor muscles, to bulge outward. [3][4][5][6][7][8][9][10][11][12][13][14][15] Other authors suggest that this anomaly may represent a third or fourth branchial cleft anomaly. [16][17][18][19] Failed closure of these branchial clefts may result in a cyst, fistula, or sinus.…”

“…[3][4][5][6][7][8][9][10][11][12][13][14][15] This description fails to address intraluminal anatomy or some of the important surrounding structures, including the thyroid cartilage and superior laryngeal neurovascular bundle. [3][4][5][6][7][8][9][10][11][12][13][14][15] This description fails to address intraluminal anatomy or some of the important surrounding structures, including the thyroid cartilage and superior laryngeal neurovascular bundle.…”

“…The outpouching of a pharyngocele through the thyrohyoid membrane does not have an agreed upon etiology. Most authors posit that increased intraluminal pressure causes inherent weak areas of the pharynx, the areas between the overlapping constrictor muscles, to bulge outward . Other authors suggest that this anomaly may represent a third or fourth branchial cleft anomaly .…”

The pharyngocele: infrequently encountered and easily misdiagnosed

“…Over a two-year period Norris (1979) saw 24 patients with this condition and Wilson (1962) suggested it was not uncommon if looked for, especially in the elderly. Other authors (Ward et al, 1963;Mantoni and Ostri, 1987;Obana and Fee, 1987) on the other hand called it a very rare condition. In the literature many terms are used for this condition, such as Zenker's diverticulum or branchial clefts, cysts and fistulas.…”