OBJECTIVE: To summarize the diagnostic and therapeutic experience of primary cricopharyngeal achalasia and introduce new operandi modus. METHOD: Report the two cases we treated in 2008 and integrate published literature, and approach its diagnostic and therapeutic experience and make use of new operandi modus. RESULT: The diagnosis of primary cricopharyngeal achalasia is difficult, and we must apply exclusive diagnosis according to the examinations of fibrolaryngoscopy, esophagoscopy and barium meal et al. CONCLUSION Surgical treatment is the best option. Partial resection of cricopharyngeal muscle and upper esophageal ring-shaped muscle is superior to simple cricopharyngeal myotomy.
Aged ; Esophageal Achalasia ; diagnosis ; surgery ; Female ; Humans ; Middle Aged ; Pharyngeal Diseases ; diagnosis ; surgery ; Pharyngeal Muscles ; physiopathology

Carcinoma ; Fistula ; Humans ; Hypopharyngeal Neoplasms/surgery* ; Hypopharynx ; Pharyngeal Diseases

Humans ; Pyriform Sinus/surgery* ; Thyroid Neoplasms/diagnosis* ; Fistula/surgery* ; Diagnostic Errors ; Pharyngeal Diseases/surgery*

We report the treatment of one patient with pharynx anastomotic stenosis after cervical esophagealresection by stent implantation. The patient suffered from serious pharynx anastomotic stenosis after gastric-pha-ryngeal anastomosis. After balloon-dilatation,a domestic self-expanding Z-stents was implanted in the stricture ofthe esophagus under the X-rays. After stent implantation, the patient has been leading a normal life for threeyears. Balloon dilatation and stent implantation is an effective and safe method in the treatment of patients withpharynx anastomotic stenosis.
Anastomosis, Surgical ; Catheterization ; Constriction, Pathologic ; Esophageal Stenosis ; surgery ; Esophagus ; surgery ; Humans ; Pharyngeal Diseases ; Pharynx ; surgery ; Stents

OBJECTIVETo study the short-term results and technological improvement of free anterolateral thigh (ALT) flaps in the reconstruction of circumferential hypopharyngeal defects.

METHODSThe free ALT flap with a reporter skin paddle was used in 22 cases with circumferential hypopharyngeal defects. The short-term results of reconstructive surgeries and key points, advantages and complications of this technique were summarized.

RESULTSThe length of circumferential hypopharyngeal defects ranged from 7 to 9 cm. ALT flap with an area of (8-9) cm × (11-18) cm was harvested. A reporter skin island with the skin area of (2.0-3.0) cm × (2.5-4.0) cm was designed. 91% (20/22) of ALT flaps survived. Two cases with flap necrosis underwent second reconstruction with a pedicled pectoralis major flap. All the patients had patent anastomotic lumen. Good postoperative subjective swallowing evaluation was obtained in 59% (13/22) of patients; 41% (9/22) of patients had acceptable swallowing results. Three patients (14%) presented with postoperative pharyngocutaneous fistula. One case recovered spontaneously in short-term and other two cases received the second reconstructive surgery.

CONCLUSIONSThe application of free ALT flap with a reporter skin paddle in the reconstruction of circumferential hypopharyngeal defect is technologically easy and reliable, with satisfying swallowing function and limited trauma.

Free Tissue Flaps ; Humans ; Hypopharynx ; pathology ; surgery ; Pharyngeal Diseases ; surgery ; Reconstructive Surgical Procedures ; Skin Transplantation ; Thigh

Fibrovascular polyp of the hypopharynx and esophagus, a rare, benign, intraluminal and submucosal tumor, is most commonly originated from the proximal esophagus. We discussed four cases with regurgitation, respiratory symptom or the feeling of a mass in the throat. All the patients were examined with laryngoscope under general anesthesia. A transverse cervical incision was performed in one patient and the polyps were excised under laryngoscope with CO2 laser in the other three patients. All the lesions were removed successfully. Diagnostic and therapeutic principles involved in these cases are presented and discussed. The recognition of fibrovascular polyp of the hypopharynx and esophagus as a potential cause of regurgitation is paramount. Surgical excision is recommended because of the satisfactory outcome.
Adult ; Aged ; Aged, 80 and over ; Esophageal Diseases ; surgery ; Female ; Humans ; Hypopharynx ; Male ; Middle Aged ; Pharyngeal Diseases ; surgery ; Polyps ; surgery

Bronchoscopy ; Cysts ; congenital ; surgery ; Humans ; Infant ; Laryngeal Diseases ; congenital ; surgery ; Lasers, Solid-State ; Pharyngeal Diseases ; congenital ; surgery

OBJECTIVETo observe the morphologic features of cricopharyngeal muscle (CPM) under suspension laryngeal endoscope.

METHODSThis prospective study was conducted on a series of 100 consecutive patients who undergone endoscopic microlaryngeal surgery with intubation general anesthesia. The suspension laryngoscope was introduced down to postcricoid area approaching esophageal inlet. By lifting the larynx with the laryngoscope, the mucosa-covered cricopharyngeal muscle was easily identified as the mound of tissue just at the posterior pharyngeal wall. The image of cricopharyngeal muscle under the laryngoscope was saved.

RESULTSIn 94 out of 100 patients, CPM could be visualized with laryngoscope. In the other 6 patients, both CPM and glottic could not be exposed because of cervical vertebra stiffness and obesity. According to the image of CPM under the laryngoscope, the shape of the CPM was divided into three types. It was named for flat type in which there was no mound of tissue visible at the posterior pharyngeal wall and esophageal cavity could be visible completely, semi-bar type in which there was a bar at the posterior pharyngeal wall and partial esophageal cavity could be visible and full-bar type in which the bar contact esophageal anterior wall and esophageal cavity could not be visible. There were 14(14.9%) patients as flat type, 59(62.8%) as semi-bar type and 21(22.3%) as full-bar type. No significant difference was found between adults group and the aged (≥ 65 years old) group (χ(2) = 1.224, P = 0.747) and reflux associated group and non-reflux associated group respectively (χ(2) = 5.252, P = 0.072).

CONCLUSIONSThe CPM could be well exposed in most of the patients with suspension laryngeal endoscope. It provides anatomy basis for endoscopic cricopharyngeal myotomy.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Laryngeal Diseases ; pathology ; Laryngoscopy ; Male ; Middle Aged ; Pharyngeal Diseases ; pathology ; Pharyngeal Muscles ; pathology ; surgery ; Prospective Studies ; Young Adult

Infant, Newborn ; Humans ; Pyriform Sinus/surgery* ; Neck ; Fistula/congenital* ; Retrospective Studies ; Pharyngeal Diseases/congenital*

OBJECTIVETo analyze the relationship between pharyngeal paraesthesia and abnormal styloid process, and to evaluate the surgery outcome.

METHODSOne hundred and four patients with styloid process abnormality, especially those with pharyngeal paraesthesia were studied preoperatively and postoperatively.

RESULTSAmong 104 patients who complained about foreign body sensation of the pharynx and a sore throat, after partial removal of styloid process, 71.2% (74/104) cured (symptoms disappeared), 12.5% (13/104) improved, while 16.3% (17/104) had no improvement. The responding rate was 83.7% (87/104).

CONCLUSIONSNot all abnormality of styloid process subjects would have pharyngeal paraesthesia, so for this kind of cases a more comprehensive analysis is necessary. Surgery via mouth is preferable.

Adult ; Aged ; Female ; Humans ; Middle Aged ; Paresthesia ; surgery ; Pharyngeal Diseases ; surgery ; Temporomandibular Joint Dysfunction Syndrome ; surgery ; Treatment Outcome ; Young Adult