Endoscopic
laser resection of hypopharyngeal
diverticula has been used in the ENT Department, Odense, Denmark, since 1989. The outcome of treatment is reported in this presentation. Of the 61 patients, 32 (52%) were males. Age at operation was 72 years (median), range 37-94 years. The diagnosis in all patients was confirmed by
barium radiography of the hypopharynx and the oesophagus. A Benjamin-Hollinger diverticuloscope was used for viewing the tissue bridge separating the
diverticulum and the oesophagus. The tissue bridge was cut from the apex to the base using a
CO2 laser. Perioperative complications were seen in 6 patients:
Bleeding (1),
subcutaneous emphysema without (3) or with (1)
inflammation,
inflammation without
emphysema (1). The duration of postoperative nasogastric feeding was 2 days (median) (range 1-11 days). Fifty-four patients received prophylactic
antibiotic treatment for a median of 3 days (range 0.5-13 days). The duration of postoperative hospitalization was 3 days (median) (range 2-14 days). The patients were routinely examined 2-3 months postoperatively. There were recurrences in 6 patients (10%), all successfully re-operated. A follow-up questionnaire was sent to patients who had finished their postoperative examination in March 1999. All 37 patients still alive responded. Median follow-up time was 37 months (range 3-96 months). Two patients reported recurrence at the time of follow-up and have been successfully re-operated. Eight patients reported minor and intermittent symptoms that did not indicate further evaluation. We conclude that
laser resection of hypopharyngeal
diverticula is an efficient
therapy, which is applicable to and well tolerated in the great majority of patients. The rate of recurrence is low and re-operation can be performed without difficulty.