ASPIRATION RESULTING FROM LATERAL HYPOPHARYNGEAL POUCHES

OBJECTIVE. This study was performed to evaluate the frequency of postd eglutitive aspiration in lateral hypopharyngeal pouches and to correla te postdeglutitive aspiration to pouch size and dynamics. MATERIALS AN D METHODS. Two radiologists retrospectively analyzed 325 videofluorogr aphy examinations of patients swallowing. The 325 patients were 22-81 years old, 173 men and 152 women. Patients who had undergone surgery o f the hypopharynx were excluded from the study. All pouches found on v ideofluorography were classified into grade I, II, or III. Because iod inated contrast agent had been used initially, patients who had no or minimal aspiration underwent a second imaging examination using high-d ensity barium. RESULTS. Of the 325 patients, 118 had lateral hypophary ngeal pouches: 77 bilateral and 41 unilateral. Postdeglutitive aspirat ion was diagnosed in 14 (56%) of the 25 grade III pouches and in two ( 3%) of the 58 grade II pouches. Aspiration was not seen in any of the 112 grade I pouches. CONCLUSION. The prevalence of postdeglutitive asp iration is high in patients who have grade III pouches. To date, no ap propriate conservative treatment has been described; however, in sever e cases surgery is warranted.