Diverticula of the larynx and pharynx (喉部及咽部憩室)

Pharyngeal pouch (咽囊)

Aetiology:

A pharyngeal pouch develops from a herniation of pharyngeal mucosa through Killian’s dehiscence.

Clinical features:

Dysphagia and regurgitation of food occur. Large pouches may cause aspiration pneumonia. Pooling of saliva in the hypopharynx may be noted on indirect laryngoscopy. Barium swallow confirms the diagnosis.

Management:

Following an endoscopy to exclude an associated carcinoma, the pouch may be excised via an external approach or the wall between the pouch and oesophagus divided endoscopically using a stapling gun.

Laryngocele (喉膨出)

Aetiology:

Distension of the laryngeal saccule can produce an internal or external laryngocele.

Clinical features:

Hoarseness or dysphagia may occur. External laryngoceles may produce a swelling in the neck accentuated by performing Valsalva’s manoeuvre. Laryngeal tomograms taken during this manoeuvre will demonstrate the laryngocele.

Management:

Following endoscopy to exclude an associated carcinoma, an internal laryngocele can be ‘uncapped’ whilst an external laryngocele is excised through the neck.