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

Bilateral saccular cysts

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

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


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.

MALT lymphoma

October 31, 2010     Kristin K. Marcum, MD, E. Shannon Kemp, CCC-SLP, and Catherine J. Rees, MD

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


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

Endoscopic cricopharyngeal myotomy for Zenker diverticulum using the harmonic scalpel

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

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


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.

An island of normal mucosa in a sea of Barrett metaplasia

February 1, 2010     David A. Knuff, MD and Albert L. Merati, MD

Jugular fossa meningioma: Presentation and treatment options

September 30, 2009     Amy L. Rutt, DO, Xiaoli Chen, MD, and Robert T. Sataloff, MD, DMA, FACS


Primary jugular fossa meningiomas are among the rarest subtypes of meningioma. They are intimately related to the lower cranial nerves, the jugular bulb and vein, and the temporal bone, and they have a tendency to extend both intra- and extracranially. The most common morbidity associated with jugular fossa lesions is lower cranial nerve deficits. In these cases, the differential diagnosis and preoperative radiographic diagnosis are very important because preoperative management and operative planning for the jugular fossa subtype differ considerably from those of other types of meningioma. Because of the rarity of this condition, our understanding of its treatment, long-term follow-up, and recurrence is limited. As experience with radiosurgical treatment of all meningiomas is accumulating, we may find that radiosurgery of jugular fossa meningiomas is appropriate. In the meantime, cure is still possible with complete surgical resection, and surgical morbidity can be minimized through meticulous planning and surgical technique. We describe a case of primary jugular fossa meningioma in a 45-year-old man who presented with complaints of chronic left aural fullness, hearing loss, and difficulty understanding voices. Imaging revealed the presence of a destructive jugular fossa mass. The patient underwent surgical resection without complication, and he was free of recurrence at 1 year of follow-up.

Partial esophageal obstruction from anterior cervical spine hardware

August 31, 2009     Carissa Portone, CCC-SLP, Justin S. Golub, BA, and Michael M. Johns III, MD

A decade of unexplained dysphagia

May 31, 2009     Christopher Burgess, BM, BCh, Richard Hughes, MRCS, Stewart Griffiths, FRCS (SN), and Thomas Cadoux-Hudson, FRCS (SN)
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