Pharyngoceles of the hypopharynx

The differential diagnosis of the complaint of dysphagia is extensive; however, a search of the literature gives the impression that pharyngocele as a cause of dysphagia is relatively infrequent, since only 18 well-documented cases have been reported. On the other hand, the author's experience reveals that pharyngocele occurs more commonly than indicated in the literature as, over the past 2 years, 24 patients with pharyngocele have been personally observed. This thesis is divided primarily into three sections: 1. a review of the physiology and anatomy involved in the swollowing mechanism; 2. a review of the English literature regarding pharyngocele, and 3. an evaluation of the author's 24 cases, allowing for discussion and conclusions. It is noted that laryngocele is frequently mistaken for pharyngocele; however, it is pointed out that a correctly performed barium swallow roentgenogram differentiates one from the other. Symptoms of laryngocele, Zenker's diverticulum and pharyngocele can be quite similar. Frequently, pharyngocele can be demonstrated by the Valsalva maneuver. Surgical repair is indicated when the symptoms are severe. Standard pharyngeal mucous membrane closure similar to the procedure utilized in the repair of Zenker's diverticulum should result in resolution of the problem.