PMID- 32885301
OWN - NLM
STAT- MEDLINE
DCOM- 20211124
LR  - 20220202
IS  - 1432-0460 (Electronic)
IS  - 0179-051X (Print)
IS  - 0179-051X (Linking)
VI  - 36
IP  - 4
DP  - 2021 Aug
TI  - Heterogeneous Presentations of Pharyngoesophageal Diverticula Occurring after 
      Cervical Spine Surgery.
PG  - 689-699
LID - 10.1007/s00455-020-10184-1 [doi]
AB  - Dysphagia after anterior cervical spine surgery (ACSS) may be secondary to 
      pharyngoesophageal diverticulum. Our objectives are to (1) highlight the 
      heterogeneity in clinical presentation, (2) discuss pathophysiology and 
      management, and (3) present a comprehensive literature review of these 
      diverticula. All patients undergoing pharyngoesophageal diverticulum repair 
      between 2013 and 2019 were identified. Cases with ACSS history underwent detailed 
      review of clinical presentation, assessment, and management. Literature review 
      and analysis of all reported ACSS-associated pharyngoesophageal diverticula was 
      performed. Two hundred forty-three cases of pharyngoesophageal diverticulum 
      repair were performed during the study period; 13 cases were ACSS-associated. 
      Four types of clinical presentation were identified: (Type A) Spinal hardware 
      present, with videofluoroscopic evidence of exposed hardware; (Type B) Spinal 
      hardware present, without videofluoroscopic evidence of exposed hardware; (Type 
      C) Spinal hardware absent due to prior spinal hardware removal or ACSS performed 
      without hardware; and (Type D) Concurrent esophago-esophageal fistula (EEF) 
      present. All of our cases were evaluated using modified barium swallow study and 
      esophagoscopy and definitively managed with endoscopic diverticulotomy. 
      Literature review identified 21 cases of ACSS-associated pharyngoesophageal 
      diverticulum repair from 18 publications. The majority of cases were identified 
      using barium esophagram (N = 18, 86%) and managed with open diverticulectomy 
      (N = 19, 90%). There were no reports of EEF. ACSS-associated pharyngoesophageal 
      diverticulum must be evaluated with fluoroscopy and endoscopy, which determine 
      presentation type. Presentation type guides management. Esophageal perforation 
      requires hardware removal and perforation repair with flap placement. Endoscopic 
      diverticulotomy was found essential to definitive management.Level of Evidence: 
      4.
CI  - (c) 2020. Springer Science+Business Media, LLC, part of Springer Nature.
FAU - Pillutla, Pranati
AU  - Pillutla P
AUID- ORCID: 0000-0001-5765-2761
AD  - School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, 
      USA.
FAU - Juarez, Kevin O
AU  - Juarez KO
AD  - Yale School of Medicine, New Haven, CT, USA.
FAU - Smith, Alden
AU  - Smith A
AD  - Department of Head and Neck Surgery, UCLA Medical Center, 62-132 CHS, 10833 Le 
      Conte Ave, Los Angeles, CA, 90095, USA.
FAU - Long, Jennifer L
AU  - Long JL
AD  - Department of Head and Neck Surgery, UCLA Medical Center, 62-132 CHS, 10833 Le 
      Conte Ave, Los Angeles, CA, 90095, USA.
AD  - Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA.
FAU - Chhetri, Dinesh K
AU  - Chhetri DK
AD  - Department of Head and Neck Surgery, UCLA Medical Center, 62-132 CHS, 10833 Le 
      Conte Ave, Los Angeles, CA, 90095, USA. DChhetri@mednet.ucla.edu.
LA  - eng
GR  - R01 DC011300/DC/NIDCD NIH HHS/United States
PT  - Journal Article
DEP - 20200903
PL  - United States
TA  - Dysphagia
JT  - Dysphagia
JID - 8610856
SB  - IM
MH  - Cervical Vertebrae/diagnostic imaging/surgery
MH  - *Esophageal Perforation
MH  - Esophagoscopy
MH  - Humans
MH  - Postoperative Complications/etiology
MH  - *Zenker Diverticulum/etiology/surgery
PMC - PMC8132548
MID - NIHMS1702424
OTO - NOTNLM
OT  - Anterior cervical spine surgery
OT  - Dysphagia
OT  - Endoscopic diverticulotomy
OT  - Pharyngoesophageal diverticulum
OT  - Spine hardware
COIS- Conflict of Interest The authors declare that they have no conflict of interest.
EDAT- 2020/09/05 06:00
MHDA- 2021/11/25 06:00
PMCR- 2022/02/01
CRDT- 2020/09/05 06:00
PHST- 2020/07/01 00:00 [received]
PHST- 2020/08/24 00:00 [accepted]
PHST- 2020/09/05 06:00 [pubmed]
PHST- 2021/11/25 06:00 [medline]
PHST- 2020/09/05 06:00 [entrez]
PHST- 2022/02/01 00:00 [pmc-release]
AID - 10.1007/s00455-020-10184-1 [pii]
AID - 10.1007/s00455-020-10184-1 [doi]
PST - ppublish
SO  - Dysphagia. 2021 Aug;36(4):689-699. doi: 10.1007/s00455-020-10184-1. Epub 2020 Sep 
      3.