Lateral pharyngeal diverticulum
Introduction
Introduction to the pharyngeal wall The pharyngeal wall diverticulum has different performance depending on the size and position. The small diverticulum may have symptoms such as bad breath, pharyngeal obstruction, foreign body sensation and food reflux. Large diverticulum can have difficulty swallowing and hoarseness. The disease is more common, more common in musical instruments and the elderly. According to the medical history, the clinical manifestations can be diagnosed, diverticulum inflation, swallowing or sputum angiography can be clearly diagnosed, esophagoscopy can be found in the diverticulum, and conservative surgery can be performed. According to the size and position of the diverticulum, the small diverticulum can be asymptomatic. Due to the presence of the diverticulum, there may be bad breath, pharyngeal obstruction, foreign body sensation, food reflux and other symptoms. Large diverticulum may have difficulty swallowing, hoarseness, The body can be found in the tonsil nest, the epiglottis, the pear-shaped fossa, etc. have small openings, sometimes probes can be probed into the chamber, the neck can touch the mass that expands and contracts with the air pressure, or pinches the nose When blowing, a soft cystic mass appears on the side wall of the neck, the drum sounds or the sense of fluctuating, the pressure can be reduced, and there is a clucking sound or a liquid overflowing from the mouth. basic knowledge The proportion of illness: 0.001% Susceptible people: more common in musical instruments and seniors Mode of infection: non-infectious Complications: difficulty swallowing
Cause
Pharyngeal wall diverticulum
The cause is unknown and may be related to the following factors:
1 congenital factors: the area of the nail membrane is the third pharyngeal sac opening, and some people think that the side wall diverticulum is the extension of the third pharyngeal sac or the fourth pharyngeal sac, but some people disagree;
2 The theory of increased intra-pharyngeal pressure: thought to be related to cyclop the pharyngeal muscle and esophageal dysfunction and increased intra-pharyngeal pressure;
3 senile pharyngeal wall weakness: Seaman noticed that this diverticulum often occurs in the elderly and is considered normal, the diverticulum in the pharyngeal opening in the tonsil fossa, epiglottis and pear-shaped fossa, sometimes multiple, the most common type is swallow The mucosa passes through the anterior and lateral wall of the piriform fossa in the same plane as the epiglottis of the thyroid gland. The periosteum of the thyroid gland is not supported by cartilage or bone. The pharyngeal muscle contraction muscle does not completely cover it. The blood vessels and the superior larynx pass through the area, and after the diverticulum is formed, the weight of the contents can gradually increase the diverticulum.
Prevention
Pharyngeal wall diverticulosis prevention
Without effective preventive measures, the asymptomatic pharyngeal diverticulum can be left untreated, and the pharyngeal chamber caused by forced blowing can stop the diverticulum and the symptoms disappear.
Complication
Pharyngeal wall diverticulum complications Complications, difficulty swallowing
May have bad breath, pharyngeal obstruction, foreign body sensation, food reflux and other symptoms, large diverticulum can have difficulty swallowing, hoarseness, physical examination can be found in tonsil fossa, epiglottis, pear-shaped fossa and other small openings, Sometimes the probe can be used to penetrate into the chamber, and the neck can touch the mass that expands and contracts with the air pressure.
Symptom
Pharyngeal wall diverticulum symptoms common symptoms bad breath swallowing cystic mass
According to the medical history, the clinical manifestations can be diagnosed, diverticulum inflation, swallowing or sputum angiography can be clearly diagnosed, esophagoscopy can be found in the diverticulum, and conservative surgery can be performed.
According to the size and position of the diverticulum, the small diverticulum can be asymptomatic. Due to the presence of the diverticulum, there may be bad breath, pharyngeal obstruction, foreign body sensation, food reflux and other symptoms. Large diverticulum may have difficulty swallowing, hoarseness, The body can be found in the tonsil nest, the epiglottis, the pear-shaped fossa, etc. have small openings, sometimes probes can be probed into the chamber, the neck can touch the mass that expands and contracts with the air pressure, or pinches the nose When blowing, a soft cystic mass appears on the side wall of the neck, the drum sounds or the sense of fluctuating, the pressure can be reduced, and there is a clucking sound or a liquid overflowing from the mouth.
Examine
Examination of the pharyngeal wall diverticulum
Diverticulum inflation, swallowing or sputum angiography can confirm the diagnosis, esophagoscopy can find the diverticulum.
Diagnosis
Diagnostic diagnosis of pharyngeal wall
The disease should be differentiated from the pharyngeal wall scar cyst, which usually follows the development of the pharynx. Due to the formation of scar tissue and patients with inflammatory lesions such as infection, scar tissue often pulls the normal posterior pharyngeal wall. In the diverticulum, the bacterial infection of the diverticulum can form an abscess, which can be clearly distinguished according to whether the patient has a history of surgery and laryngoscopy.
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