Newer techniques are now being used to treat pharyngeal pouches including Zenker-peroral endoscopic myotomy (Z-POEM) that involves third-space endoscopy. Flexible techniques have become routine, which are associated with a clinical success rate of 91%, adverse event rate of 11.3%, and recurrence of 10.3%. In general, surgery has a high success rate (80-100%), but recurrence may be high (up to 19%) and it is associated with significant morbidity and mortality compared to endoscopic techniques. flexible endoscopic septum division)Įach technique is associated with its own risks and benefits. There are currently three methods for performing myotomy with variable success: ![]() This creates a common cavity between the pouch and the oesophageal lumen that improves symptoms. The aim of treatment for a pharyngeal pouch is to dissect the septum of the cricopharyngeal muscle that is maintaining the integrity of the pouch by performing a myotomy (i.e. For patients with symptomatic or larger pharyngeal pouches, there are a variety of treatment options that can include surgery or endoscopy. < 1cm) do not require any specific treatment. Patients who are asymptomatic or have small pouches (i.e. Patients with small, asymptomatic pouches do not require any treatment. The actual cause of the diverticulum is unclear, although several factors have been proposed such as abnormal motility and increased pressure during bolus transfer of food to the oesophagus. The hypopharynx continues the final stage of swallowing. herniation of the pharyngeal mucosa and submucosa through this gap in the muscular arrangement). It is funnel-shaped and bound by the middle and inferior constrictor muscles. The orientation of these muscle fibres creates a triangular gap (or weakness), known as Killian’s triangle, that is prone to the formation of a diverticulum (i.e. Hypopharyngeal mucosal space Postcricoid hypopharynx ( lower anterior wall ). The inferior pharyngeal constrictor is composed of the thyropharyngeus muscle superiorly and the cricopharyngeal muscle inferiorly. muscle Stylohyoid ligament Middle pharyngeal constrictor muscle Inferior. The pharynx contains three major constrictor muscles (superior, middle, inferior) that are involved in swallowing and speaking. ![]() The pharynx is involved in the movement of air from the nasal and oral cavities to the larynx, as well as the movement of food to the oesophagus.
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