Pharyngesophageal Diverticula Following Anterior Cervical Discectomy and Fusion

被引:0
|
作者
Beesley, Hassan [1 ]
Piraquive, Jacquelyn [2 ]
Jaleel, Zaroug [1 ]
Tracy, Lauren F. [1 ,2 ]
机构
[1] Boston Univ, Sch Med, Boston, MA 02118 USA
[2] Boston Med Ctr, Dept Otolaryngol Head & Neck Surg, Boston, MA USA
来源
ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY | 2023年 / 132卷 / 07期
关键词
pharyngeosophageal diverticulum; anterior cervical discectomy and fusion; traction diverticulum; hypopharyngeal diverticulum; dysphagia; miscellaneous; SPINE SURGERY; PHARYNGOESOPHAGEAL DIVERTICULUM; PHARYNGEAL DIVERTICULUM; SURGICAL-MANAGEMENT; DYSPHAGIA; COMPLICATION; PERFORATION; RESECTION; FISTULA; DISEASE;
D O I
10.1177/00034894221115745
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objectives: Development of traction pharyngesophageal diverticula following anterior cervical discectomy and fusion (ACDF) is a rare but morbid cause of dysphagia and the optimal surgical management is unclear. Methods: PubMed, GoogleScholar, Embase database reviews of "traction diverticula/um + anterior cervical/ACDF." Patient demographics, presenting symptoms, surgical technique, and outcomes were compared. Results: Seventeen manuscripts reported 21 cases of pharyngesophageal diverticulum (PED) following ACDF (10 F:11 M, mean age 45 years). Presenting symptoms included dysphagia (n = 18), regurgitation (n = 10), and weight loss (n = 6). The average interval to presentation was 4.5 years after ACDF (range: 6 months-18 years) and ACDF levels most commonly involved were C5-C6 and/or C6-C7 (n = 12). Open diverticulectomy with (n = 12) and without (n = 6) cricopharyngeal myotomy was the most common approach and reinforcement with vascularized tissue was used in 6 patients (29%). Attempted endoscopic diverticula repair was successful in 1 patient, was converted to open repair in 5 patients, and 1 patient did not have surgical repair. ACDF hardware was removed in 11 cases (52%) and was routinely removed when concomitant infection was present. Complications following repair were reported in 6 patients (30%). Conclusion: Traction pharyngesophageal diverticula are a rare cause of dysphagia which occur after a variable interval following ACDF. Open surgical diverticulectomy yields superior outcomes compared to the endoscopic approach. In the setting of infection hardware removal is recommended. Vascularized tissue reinforcement can limit potential esophageal leak; however, the risk of post-operative complications remains high.
引用
收藏
页码:800 / 805
页数:6
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