Skip to main content
Book cover

Dysphagia pp 425–443Cite as

Surgical Aspects of Pharyngeal Dysfunction, Dysphagia, and Aspiration

  • Chapter
  • 5257 Accesses

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Surgical treatment of oropharyngeal dysphagia and aspiration resulting from different disorders is a difficult issue. Sometimes the aim of the surgery is complete correction of the disorder (e.g., extraluminal obstruction), but more often no more than a reduction of the symptoms can be achieved (e.g., laryngeal suspension). The most frequent disorders eligible for surgical treatment are described and some others are described as examples of possible surgical approaches. The surgical techniques described are aimed at preservation or restoration of the function of the larynx and pharynx.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   229.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Akhtar S, O’Flynn PE, Kelly A, Valentine PM (2000) The management of dysphagia in skeletal hyperostosis. J Laryngol Otol 114:154–157

    Article  PubMed  CAS  Google Scholar 

  • Aviv JE, Mohr JP, Blitzer A et al (1997) Restoration of laryngopharyngeal sensation by neural anastomosis. Arch Otolaryngol Head Neck Surg 123:154–160

    Article  PubMed  CAS  Google Scholar 

  • Bensaid AH, Dietmann JL, Kastler B et al (1992) Neurofibromatosis with dural ectasia and bilateral symmetrical pedicular clefts: report of two cases. Neuroradiology 34:107–109

    Article  PubMed  CAS  Google Scholar 

  • Brandenberg G, Leibrock LG (1986) Dysphagia and dysphonia secondary to anterior cervical osteophytes. Neurosurgery 18:90–93

    Article  PubMed  CAS  Google Scholar 

  • Brigand C, Ferraro P, Martin J, Duranceau A (2007) Risk factors in patients undergoing cricopharyngeal myotomy. Br J Surg 94:978–983

    Article  PubMed  CAS  Google Scholar 

  • Calcatarra T (1971) Laryngeal suspension after supraglottic laryngectomy. Arch Otol 94:306–309

    Article  Google Scholar 

  • Carrau RL, Cintron FR, Astor F (1990) Transcervical approaches to the prevertebral space. Arch Otolaryngol Head Neck Surg 116:1071–1073

    Article  Google Scholar 

  • Christiaens P, De Roock W, Van Olmen A, Moons V, D’Haens G (2007) Treatment of ZD through a flexible endoscope with a transparent oblique-end hood attached to the tip and a monopolar forceps. Endoscopy 39(2):137–140

    Article  PubMed  CAS  Google Scholar 

  • Coiffier L, Périé S, Laforêt P, Eymard B, St Guily JL (2006) Long-term results of cricopharyngeal myotomy in oculopharyngeal muscular dystrophy. Otolaryngol Head Neck Surg 135:218–222

    Article  PubMed  Google Scholar 

  • Collard JM, Otte JB, Kestens PJ (1993) Endoscopic stapling technique of esophagodiverticulostomy for ZD. Ann Thorac Surg 56:573–576

    Article  PubMed  CAS  Google Scholar 

  • Cook IJ (1993) Cricopharyngeal function and dysfunction. Dysphagia 8:244–251

    Article  PubMed  CAS  Google Scholar 

  • Cook IJ, Kahrilas PJ (1999) AGA technical review on management of oropharyngeal dysphagia. Gatroenterology 116:455–478

    Article  CAS  Google Scholar 

  • Cook RD, Huang PC, Richtsmeier WJ, Scher RL (2000) Endoscopic staple-assisted esophagodiverticulostomy: an excellent treatment of choice for ZD. Laryngoscope 110:2020–2025

    Article  PubMed  CAS  Google Scholar 

  • de Boer MF, Pruyn JF, van den Borne B, Knegt PP, Ryckman RM et al (1995) Rehabilitation outcomes of long-term survivors treated for head and neck cancer. Head Neck 17(6):503–515

    Article  PubMed  Google Scholar 

  • Desprez JD, Kiehn CL (1959) Method of reconstruction following resection of the anterior oral cavity and mandible for malignancy. Plast Reconstr Surg 24:238–249

    Article  CAS  Google Scholar 

  • Dohlman G, Mattson O (1960) The endoscopic operation for hypopharyngeal diverticula. Arch Otolaryngol 71:744–752

    Article  CAS  Google Scholar 

  • Edgerton MT, Duncan MM (1959) Reconstruction with loss of the hyomandibular complex in excision of large cancers. Arch Surg 78:425–436

    Article  CAS  Google Scholar 

  • Erkulurawatra S, El Gammal T, Hawkins JB et al (1979) Intrathoracic meningoceles and neurfibromatosis. Arch Neurol 36:557–559

    Article  Google Scholar 

  • Flint PW, Purcell LL, Cummings CW (1997) Pathophysiology and indications for medialization thyroplasty in patients with dysphagia and aspiration. Otolaryngol Head Neck Surg 116:349–354

    Article  PubMed  CAS  Google Scholar 

  • Freund B, Timon C (1992) Cervical meningocele presenting as a neck mass in a patient with neurofibromatosis 1. J Laryngol Otol 106:463–464

    Article  PubMed  CAS  Google Scholar 

  • Fujimoto Y, Hasegawa Y, Yamada H et al (2007) Swallowing function following extensive resection of oral or oropharyngeal cancer with laryngeal suspension and cricopharyngeal myotomy. Laryngoscope 117:1343–1348

    Article  PubMed  Google Scholar 

  • Giger R, Dulguerov P, Payer M (2006) Anterior cervical osteophytes causing dysphagia and dyspnea: an uncommon entity revisited. Dysphagia 21(4):259–263

    Article  PubMed  Google Scholar 

  • Girgis JH, Guirguis NN, Mourice M (1982) Laryngeal and pharyngeal disorders in vertebral ankylosing hyperostosis. J Laryngol Otol 96:659–664

    Article  PubMed  CAS  Google Scholar 

  • Goode RL (1976) Laryngeal suspension in head and neck surgery. Laryngoscope 86:349–355

    Article  PubMed  CAS  Google Scholar 

  • Guily JL, Perie S, Willig TN, Chaussade S, Eymard B, Angelard B (1994) Swallowing disorders in muscular diseases: functional assessment and indications of cricopharyngeal myotomy. Ear Nose Throat J 73:34–40

    Google Scholar 

  • Habal MB, Murray JE (1972) Surgical treatment of life-endangering chronic aspiration pneumonia: use of an epiglottic flap to the arytenoids. Plast Reconstr Surg 59:305–311

    Article  Google Scholar 

  • Hatlebakk JG, Castell JA, Spiegel J, Paoletti V, Katz PO, Castell DO (1998) Dilatation therapy for dysphagia in patients with UES dysfunction–manometric and symptomatic response. Dis Esophagus 11:254–259

    PubMed  CAS  Google Scholar 

  • Hawthorne M, Gray R, Cottam C (1987) Conservative laryngectomy (an effective treatment for severe aspiration in motor neurone disease). J Laryngol Otol 101:283–285

    Article  PubMed  CAS  Google Scholar 

  • Kahrilas PJ, Dodds WJ, Dent J et al (1988) Upper esophageal sphincter function during deglutition. Gastroenterology 95:52–62

    PubMed  CAS  Google Scholar 

  • Kaplan S (1951) Paralysis of deglutition, a post-poliomyelitis complication treated by section of the cricopharyngeus muscle. Ann Surg 133:572–573

    PubMed  CAS  Google Scholar 

  • Kelly JH (2000) Management of UES disorders: indications and complications of myotomy. Am J Med 108:43S–46S

    Article  PubMed  Google Scholar 

  • Kitahara S, Ikeda M, Ohmae Y et al (1993) Laryngeal closure at the level of the false vocal cord for the treatment of severe aspiration. J Laryngol Otol 107:826–828

    Article  PubMed  CAS  Google Scholar 

  • Kos MP, David EF, Aalders IJ, Smit CF, Mahieu HF (2008) Long-term results of laryngeal suspension and UES myotomy as treatment of life-threatening aspiration. Ann Otol Rhinol Laryngol 117:574–580

    PubMed  Google Scholar 

  • Kos MP, David EF, Mahieu HF (2009) Endoscopic CO2-laser Zenker’s diverticulotomy revisited. Ann Otol Rhinol Laryngol 118(7):512–518

    PubMed  Google Scholar 

  • Kos MP, David EF, Klinkenberg-Knol EC, Mahieu HF (2010) Long-term results of external UES myotomy for oropharyngeal dysphagia. Dysphagia 25(3):169–176

    Article  PubMed  Google Scholar 

  • Krause P, Castro WH (1994) Cervical hyperostosis: a rare cause of dysphagia. Case description and bibliographical survey. Eur Spine J 3:56–58

    Article  PubMed  CAS  Google Scholar 

  • Laurell G, Kraepelien T, Mavroidis P, Lind BK, Fernberg JO et al (2003) Stricture of the proximal esophagus in head and neck carcinoma patients after radiotherapy. Cancer 97:1693–1700

    Article  PubMed  Google Scholar 

  • Laurian N, Shvili Y, Zohar Y (1986) Epiglotto-aryepiglottopexy: a surgical procedure for severe aspiration. Laryngoscope 96:78–81

    Article  PubMed  CAS  Google Scholar 

  • Leder SB, Acton LM, Lisitano HL, Murray JT (2005) Fiberoptic endoscopic evaluation of swallowing (FEES) with and without blue-dyed food. Dysphagia 20:157–162

    Article  PubMed  Google Scholar 

  • Lindeman RC (1975) Diverting the paralysed larynx: a reversible procedure for intractable aspiration. Laryngoscope 85:157–180

    Article  PubMed  CAS  Google Scholar 

  • Mahieu HF, de Bree R, Dagli SA, Snel AM (1996) The pharyngoesophageal segment: endoscopic treatment of ZD. Dis Esophagus 9:12–21

    Google Scholar 

  • Maple JT, Petersen BT, Baron TH, Kasperbauer JL, Wong Kee Song LM, Larson MV (2006) Endoscopic management of radiation-induced complete upper esophageal obstruction with an antegrade-retrograde rendezvous technique. Gastrointest Endosc 64(5):822–828

    Article  PubMed  Google Scholar 

  • Matan AJ, Hsu J, Fredrickson A (2002) Management of respiratory compromise caused by cervical osteophytes: a case report and a review of the literature. Spine J 2:456–459

    Article  PubMed  Google Scholar 

  • Mirza S, Dutt SN, Irving RM (2003) Iatrogenic perforation in endoscopie stapling divetiiculotomy for pbaryngeal pouches. J Laryngol Otol 117:93–98

    Article  PubMed  CAS  Google Scholar 

  • Moerman MB (2006) Cricopharyngeal Botox injection: indications and technique. Curr Opin Otolaryngol Head Neck Surg 14:431–436

    Article  PubMed  Google Scholar 

  • Mongomery WW (1975) Surgery to prevent aspiration. Arch Otolaryngol 101:679–682

    Article  Google Scholar 

  • Mosher HP (1917) Webs and pouches of the oesophagus: their diagnosis and treatment. Surg Gyn Obstet 25:175–187

    Google Scholar 

  • Oga M, Mashima T, Iwakuma T, Sugioka Y (1993) Dysphagia complications in ankylosing spinal hyperostosis and ossification of the posterior longitudinal ligament. Spine 18:391–394

    Article  PubMed  CAS  Google Scholar 

  • Petro M, Wein RO, Minocha A (2005) Treatment of a radiation-induced esophageal web with retrograde esophagoscopy and puncture. Am J Otolaryngol 26(5):353–355

    Article  PubMed  Google Scholar 

  • Piotet E, Escher A, Monnier P (2008) Esophageal and pharyngeal strictures: report on 1,862 endoscopic dilatations using the Savary-Gilliard technique. Eur Arch Otorhinolaryngol 265(3):357–364

    Article  PubMed  Google Scholar 

  • Resnick D, Shaul SR, Robins JM (1975) Diffuse idiopathic skeletal hyperostosis (DISH): Forestier’s disease with extraspinal manifestations. Radiology 115:513–524

    PubMed  CAS  Google Scholar 

  • Richter D (1995) Ventral hyperostosis of the cervical spine—a rare differential diagnosis of dysphagia. Chirurg 66:431–433

    PubMed  CAS  Google Scholar 

  • Saetti R, Silvestrini M, Peracchia A, Narne S (2006) Endoscopic stapler-assisted Zenker’s diverticulotomy: which is the best operative facility? Head Neck 28(12):1084–1089

    Article  PubMed  Google Scholar 

  • Sasaki CT, Milmoe G, Yanagisawa E (1980) Surgical closure of the larynx for intractable aspiration. Arch Otolaryngol 106:422–423

    Article  PubMed  CAS  Google Scholar 

  • Seaman DL, de la Mora Levy J, Gostout CJ, Rajan E, Knipschield M (2008) A new device to simplify flexible endoscopic treatment of ZD. Gastrointest Endosc 67:112–115

    Article  PubMed  Google Scholar 

  • Takes RP, van den Hoogen FJ, Marres HA (2005) Endoscopic myotomy of the cricopharyngeal muscle with CO2 laser surgery. Head Neck 27:703–709

    Article  PubMed  Google Scholar 

  • Tang SJ, Jazrawi SF, Chen E, Tang L, Myers LL (2008) Flexible endoscopic clip-assisted Zenker’s diverticulotomy: the first case series (with videos). Laryngoscope 118(7):1199–1205

    Article  PubMed  Google Scholar 

  • Tiwari R, Karim ABM, Greven AJ et al (1993) Total glossectomy with laryngeal preservation. Arch Otolaryngol Head and Neck Surg 119:945–949

    Article  CAS  Google Scholar 

  • Van Overbeek JJ (1997) The hypopharyngeal diverticulum. Endoscopic treatment and manometry (thesis). VanGorcum, Assen

    Google Scholar 

  • Van Overbeek JJ, Hoeksema PE, Edens E (1984) Micro-endoscopic surgery of the hypopharyngeal diverticulum using electrocoagulation or carbon dioxide laser. Ann Otol Rhinol Laryngol 93:34–36

    PubMed  Google Scholar 

  • van Twisk JJ, Brummer RJ, Manni JJ (1998) Retrograde approach to pharyngo-esophageal obstruction. Gastrointest Endosc 48(3):296–299

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hans F. Mahieu .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Mahieu, H.F., Kos, M.P. (2011). Surgical Aspects of Pharyngeal Dysfunction, Dysphagia, and Aspiration. In: Ekberg, O. (eds) Dysphagia. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_357

Download citation

  • DOI: https://doi.org/10.1007/174_2011_357

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-17886-3

  • Online ISBN: 978-3-642-17887-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics