Siddiq M A, Sood S, Strachan D
Department of Otorhinolaryngology, Head and Neck Surgery, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK.
Postgrad Med J. 2001 Aug;77(910):506-11. doi: 10.1136/pmj.77.910.506.
Pharyngeal pouches occur most commonly in elderly patients (over 70 years) and typical symptoms include dysphagia, regurgitation, chronic cough, aspiration, and weight loss. The aetiology remains unknown but theories centre upon a structural or physiological abnormality of the cricopharyngeus. A diagnosis is easily established on barium studies. Treatment is surgical via an endoscopic or external cervical approach and should include a cricopharyngeal myotomy. Unfortunately pharyngeal pouch surgery has long been associated with significant morbidity, partly due to the surgery itself and also to the fact that the majority of patients are elderly and often have general medical problems. External approaches are associated with higher complication rates than endoscopic procedures. Recently, treatment by endoscopic stapling diverticulotomy has becoming increasingly popular as it has distinct advantages, although long term results are not yet available. The small risk of developing carcinoma within a pouch that is not excised remains a contentious issue and is an argument for long term follow up or treating the condition by external excision, particularly in younger patients.
咽囊最常见于老年患者（70岁以上），典型症状包括吞咽困难、反流、慢性咳嗽、误吸和体重减轻。病因尚不清楚，但理论集中在环咽肌的结构或生理异常上。通过钡餐检查很容易确诊。治疗方法是通过内镜或颈部外入路进行手术，应包括环咽肌切开术。不幸的是，咽囊手术长期以来一直与显著的发病率相关，部分原因是手术本身，也因为大多数患者是老年人，且往往有一般的医疗问题。外部入路的并发症发生率高于内镜手术。最近，内镜吻合器憩室切开术治疗越来越受欢迎，因为它有明显的优势，尽管长期结果尚未可知。未切除的咽囊内发生癌变的小风险仍然是一个有争议的问题，这也是主张长期随访或通过外部切除治疗该病的一个理由，特别是在年轻患者中。
