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Pharyngeal pouch: comparison of surgical treatment with botulinum toxin injection to the cricopharyngeus

Published online by Cambridge University Press:  06 February 2019

K Lau  and
M G Watson
K Lau*
Affiliation:
Department of ENT, Doncaster Royal Infirmary, UK
M G Watson
Affiliation:
Department of ENT, Doncaster Royal Infirmary, UK
*
Author for correspondence: Miss Kimberley Lau, ENT Department (c/o ENT secretaries), Doncaster Royal Infirmary, Thorne Road, Doncaster DN2 5LT, UK E-mail: kimberleylau@doctors.org.uk Fax: +(0)1302 647024
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Abstract

Background

Pharyngeal pouch surgical treatments can be carried out via an endoscopic or open approach. Injection of botulinum toxin into the cricopharyngeus was first described as an alternative treatment to the more invasive surgical procedures performed for cricopharyngeal dysfunction. It has not been previously described as a treatment option for pharyngeal pouch.

Objectives

To compare operative time, average stay, complication rates and symptom control between endoscopic laser diverticulotomy, botulinum toxin injection and open procedures for pharyngeal pouch patients.

Methods

The medical records for 66 pharyngeal pouch procedures, carried out on 47 patients treated between 2011 and 2017, were identified and reviewed.

Results

The mean operative time was 21 minutes for botulinum toxin injection, 38 for endoscopic laser diverticulotomy and 104 for open surgery. The mean hospital stay was 0.6 days for botulinum toxin injection, 4.7 for endoscopic laser diverticulotomy and 4 for open surgery. The improvement in Reflux Symptom Index scores was statistically significant for both endoscopic laser diverticulotomy and botulinum toxin injection. Botulinum toxin injection had a 0 per cent complication rate.

Conclusion

Botulinum toxin injection is a safe and effective treatment for pharyngeal pouch.

Keywords

Zenker DiverticulumEndoscopyLasersBotulinum Toxin
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 2 , February 2019 , pp. 125 - 128
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Miss K Lau takes responsibility for the integrity of the content of the paper

Presented as a poster at the British Academic Conference in Otolaryngology, 4–6 July 2018, Manchester, UK.

References

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