Pharyngeal Pouch Flashcards

1
Q

What is another term for pharyngeal pouch?

A

Zenker’s diverticulum

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2
Q

What is pharyngeal pouch?

A

It is defined as a condition in which there is herniation of the pharynx through Killian’s dehiscence

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3
Q

What is Killian’s dehiscence?

A

It is a triangular area of the posterior pharyngeal wall, which is located between the thyropharyngeal and cricopharyngeal muscles

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4
Q

What are the two risk factors associated with pharyngeal pouch?

A

Older Age

Male Gender

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5
Q

What are the five clinical features associated with pharyngeal pouch?

A

Dysphagia

Regurgitation

Aspiration

Neck Swelling

Halitosis

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6
Q

What is the characteristic feature of dysphagia associated with pharyngeal pouch?

A

It is described as a sensation in which food is ‘stuck’ in the individual’s throat

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7
Q

What is the characteristic feature of neck swelling associated with pharyngeal pouch?

A

It gurgles on palpation

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8
Q

What are the two investigations used to diagnose pharyngeal pouch?

A

Fluoroscopy with Barium Enema

Ultrasound Scan

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9
Q

What is the gold standard investigation used to diagnose pharyngeal pouch?

A

Fluoroscopy with Barium Enema

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10
Q

What is a feature of pharyngeal pouch on fluoroscopy, with barium enema?

A

An outpouching of the posterior wall at the junction of the pharynx and oesophagus

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11
Q

At what vertebral level is pharyngeal pouch visualised on fluroscopy, with barium enema?

A

C5 - C6

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12
Q

When is ultrasound scan used to diagnose pharyngeal pouch?

A

It is the second line investigation used to diagnose pharyngeal pouch

It is a suitable alternative in cases where individuals present with swallowing difficulties or are intolerant of barium

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13
Q

When is conservative management of pharyngeal pouch recommended?

A

In cases where individuals are asymptomatic and the pouch measures < 1cm

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14
Q

What are the two surgical management options of pharyngeal pouch?

A

Trans-Oral Percutaneous Surgery

Cricopharyngeal Myotomy

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15
Q

When is trans-oral percutaneous surgery used to manage pharyngeal pouch?

A

It is the first line management option

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16
Q

What is trans-oral percutaneous surgery?

A

It involves endoscopy with a diverticuloscope, in which the septum between the oesophagus and the pharyngeal pouch is divided with electrocautery, laser or staples

17
Q

When is circopharyngeal myotomy used to manage pharyngeal pouch?

A

It is the second line management option

18
Q

What is circopharyngeal myotomy?

A

It It is an open surgical procedure in which there is division of the cricopharyngeal muscle, with resection of the pharyngeal pouch

19
Q

What are the five complications associated with pharyngeal pouch?

A

Aspiration Pneumonia

Pharyngeal Pouch Ulceration

Pharyngeal Pouch & Trachea Fistulation

Vocal Cord Palsy

Pharynx Squamous Cell Carcinoma