Dysphagia

Killian-Jamieson diverticulum

April 30, 2012     Ashli K. O'Rourke, MD; Paul M. Weinberger, MD; Gregory N. Postma, MD
article

Killian-Jamieson diverticulum is generally smaller than Zenker diverticulum and is associated with less dysphagia, regurgitation, and gastroesophageal reflux.

Percutaneous injection pharyngoplasty for the treatment of a pharyngocele

February 18, 2012     Amanda Hu, MD, FRCSC and Albert L. Merati, MD, FACS
article

Myoepithelioma of the vallecula: A case report

July 13, 2011     Wassim Kermani, MD, Malek Belcadhi, MD, Moncef Ben Ali, MD, Badreddine Sriha, MD, and Kamel Bouzouita, MD
article

Abstract

Myoepitheliomas are rare and generally benign neoplasms that account for fewer than 1% of all salivary gland tumors. A myoepithelioma neoplasm is almost entirely composed of myoepithelial cells and is most frequently located in the parotid gland and in the minor salivary glands of the hard palate. We report an extremely rare case of myoepithelioma of the vallecular region in a 65-year-old woman and describe this tumor's clinical peculiarity, diagnostic and therapeutic considerations, and prognosis.

Nasopharyngeal dendritic cell sarcoma, not otherwise specified, in a 34-year-old man

June 13, 2011     William B. Horton, BS, David A. Joyner, MD, William P. Daley, MD, Karen T. Pitman, MD, and Majid A. Khan, MD
article

Abstract

Dendritic cell sarcoma, not otherwise specified (NOS), is an entity that is poorly defined because of its rarity and poorly understood pathogenesis. It is characterized by positive immunohistochemical staining for S-100 and CD1a, along with an absence of cytoplasmic Birbeck granules on electron microscopy. We report the case of a surgically inaccessible nasopharyngeal dendritic cell sarcoma, NOS, in a 34-year-old man. Treatment with chemotherapy along with adjuvant radiation therapy was successful in decreasing the size of the nasopharyngeal mass, and the patient remained free of any evidence of recurrence nearly 5 years after treatment.

Bilateral saccular cysts

April 30, 2011     Anthony M. Bianchi, MD, Farhad R. Chowdhury, DO, and Robert T. Sataloff, MD, DMA, FACS
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Scleroderma

April 30, 2011     Michele P. Morrison, DO, Paul M. Weinberger, MD, and Gregory N. Postma, MD
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MALT lymphoma

October 31, 2010     Kristin K. Marcum, MD, E. Shannon Kemp, CCC-SLP, and Catherine J. Rees, MD
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Hypopharyngeal diverticulum formation following anterior discectomy and fusion: Case series

October 31, 2010     Terah J. Allis, MD, Nazaneen N. Grant, MD, and Bruce J. Davidson
article

Abstract

Pharyngoesophageal diverticulum is a rare complication following anterior cervical discectomy and fusion (ACDF). Dysphagia is a well-documented complication associated with ACDF. It may result postoperatively from a variety of etiologies, including hardware displacement, pharyngeal edema, or vocal fold paresis. One rare cause of persistent dysphagia is the formation of a hypopharyngeal diverticulum, reported in the literature in 9 previous cases. Such diverticula after ACDF surgery may have pathogenesis that is distinct from that of typical Zenker diverticula. We report 3 new cases of hypopharyngeal diverticula in patients who underwent revision ACDFs. Variables assessed included age, sex, level of fusion, ACDF-related complications, and diverticulum management. Two patients underwent successful open surgical diverticulectomy and cricopharyngeal myotomy. In the third case, the patient had a small diverticulum close to the surgical hardware and minimal symptoms and was managed conservatively. Our cases, combined with the 9 previous cases, demonstrate commonalities, particularly with regard to the risk of revision spinal surgery and infection and subsequent hypopharyngeal diverticula development. Hypopharyngeal diverticulum can occur as a complication of ACDF and should be considered in patients with persistent dysphagia after surgery. In this patient population, open resection and cricopharyngeal myotomy are recommended.

Positional dysphagia secondary to a Chiari I malformation

June 30, 2010     David L. White, MD, Catherine J. Rees, MD, Susan G. Butler, PhD, Stephen B. Tatter, MD, PhD, Lisa W. Markley, MS, CCC-SLP, and Michael S. Cartwright, MD
article

Abstract

We describe a previously unreported phenomenon: positional dysphagia secondary to a Chiari I malformation. A 38-year-old woman presented with progressive dysphagia and cough. Flexible endoscopic evaluation of swallowing detected severe pharyngeal dysphagia and aspiration, as well as an intermittent cough reflex with all consistencies in the upright position. Various compensatory strategies were attempted to relieve the aspiration, but only assumption of the supine position was successful. Subsequent magnetic resonance imaging detected a herniation of the cerebellar tonsils to the level of C2 and the presence of a cervical syrinx-findings consistent with a Chiari I malformation. After surgical decompression of the malformation, the patient's symptoms completely resolved.

Laryngeal melanosis

May 31, 2010     James R. Tate, MD and Peter C. Belafsky, MD, PhD
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Endoscopic cricopharyngeal myotomy for Zenker diverticulum using the harmonic scalpel

April 30, 2010     Jacqui Allen, MBChB, FRACS and Peter C. Belafsky, MD, PhD
article

Lingual tonsil hypertrophy causing severe dysphagia: Treatment with plasma-mediated radiofrequency-based ablation (Coblation)

March 1, 2010     Sarah E. Mowry, MD, Marvin Ament, MD, and Nina L. Shapiro, MD
article

Abstract

Lingual tonsil hypertrophy is an uncommon cause of upper aerodigestive tract pathology. We present the case of a 17-year-old boy who developed severe dysphagia and subsequent weight loss as a result of lingual tonsil hypertrophy. He was successfully treated with plasma-mediated radiofrequency-based ablation (Coblation). In the past, traditional surgical procedures for lingual tonsil hypertrophy were difficult to perform and recovery was difficult, but the introduction of Coblation has made lingual tonsillectomy much easier.

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