Abstract
The formation of posterior pharyngeal pouches is generally attributed to dysfunction of the cricopharyngeal sphincter. The reason for this dysfunction and its exact nature have not been established. Observations in the Royal Victoria Hospital, Belfast, suggested that an association exists between pharyngeal pouch and hiatus hernia. Barium studies performed in patients with a pharyngeal pouch using a described technique demonstrated the presence of a hiatus hernia in 32 out of 34 patients.
Illustrative case histories and a review of published work on cricopharyngeal function are provided to support our conclusions that gastro-oesophageal reflux is the primary factor leading to cricopharyngeal dysfunction, with the formation of a pharyngeal pouch in some cases. Several possible criticisms of this theory are discussed and the need for further investigation in patients with a pharyngeal pouch is emphasized. The management of patients with a pharyngeal pouch and hiatus hernia is briefly outlined.
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- ARDRAN G. M., KEMP F. H. The radiography of the lower lateral food channels. J Laryngol Otol. 1961 Apr;75:358–370. doi: 10.1017/s0022215100057832. [DOI] [PubMed] [Google Scholar]
- ATKINSON M., KRAMER P., WYMAN S. M., INGELFINGER F. J. The dynamics of swallowing. I. Normal pharyngeal mechanisms. J Clin Invest. 1957 Apr;36(4):581–588. doi: 10.1172/JCI103457. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Belsey R. Functional disease of the esophagus. J Thorac Cardiovasc Surg. 1966 Aug;52(2):164–188. [PubMed] [Google Scholar]
- CLAGETT O. T. PHARYNGO-ESOPHAGEAL DIVERTICULA. Surg Clin North Am. 1963 Aug;43:1165–1169. doi: 10.1016/s0039-6109(16)37052-9. [DOI] [PubMed] [Google Scholar]
- DOHLMAN G., MATTSSON O. The role of the cricopharyngeal muscle in cases of hypopharyngeal diverticula; a cineroentgenographic study. Am J Roentgenol Radium Ther Nucl Med. 1959 Apr;81(4):561–569. [PubMed] [Google Scholar]
- FYKE F. E., Jr, CODE C. F. Resting and deglutition pressures in the pharyngoesophageal region. Gastroenterology. 1955 Jul;29(1):24–34. [PubMed] [Google Scholar]
- Hunt P. S., Connell A. M., Smiley T. B. The cricopharyngeal sphincter in gastric reflux. Gut. 1970 Apr;11(4):303–306. doi: 10.1136/gut.11.4.303. [DOI] [PMC free article] [PubMed] [Google Scholar]
- KODICEK J., CREAMER B. A study of pharyngeal pouches. J Laryngol Otol. 1961 Apr;75:406–411. doi: 10.1017/s002221510005787x. [DOI] [PubMed] [Google Scholar]
- Kinley C. E. The management of hypopharyngeal diverticulum. Can J Surg. 1966 Jan;9(1):27–32. [PubMed] [Google Scholar]
- LEWIS R. S., EDWARDS W. G. The treatment of pharyngeal diverticula. Br J Surg. 1962 Jul;50:1–5. doi: 10.1002/bjs.18005021902. [DOI] [PubMed] [Google Scholar]
- Lund W. S. The cricopharyngeal sphincter: its relationship to the relief of pharyngeal paralysis and the surgical treatment of the early pharyngeal pouch. J Laryngol Otol. 1968 Apr;82(4):353–367. doi: 10.1017/s0022215100068857. [DOI] [PubMed] [Google Scholar]
- NEGUS V. E. The etiology of pharyngeal diverticula. Bull Johns Hopkins Hosp. 1957 Oct;101(4):209–223. [PubMed] [Google Scholar]
- Parrish R. M. Cricopharyngeus dysfunction and acute dysphagia. Can Med Assoc J. 1968 Dec 21;99(24):1167–1171. [PMC free article] [PubMed] [Google Scholar]
- SUTHERLAND H. D. Cricopharyngeal achalasia. J Thorac Cardiovasc Surg. 1962 Jan;43:114–126. [PubMed] [Google Scholar]
- THOMPSON H. T. CRICO-PHARYNGEAL ACHALASIA. N Z Med J. 1965 Jan;64:22–25. [PubMed] [Google Scholar]