Flexible endoscopic treatment of a pharyngeal pouch

The condition

A pharyngeal pouch forms when the lining of the pharynx (the tube running from the back of the nose and mouth to the top of the oesophagus, or gullet) bulges through the muscular wall of the pharynx. This forms a pouch where food can collect.

A pharyngeal pouch occurs mainly in older people and causes difficulty swallowing. Other symptoms include bringing up undigested food, bad breath, hoarseness and chronic cough. It is possible that lung problems such as a severe chest infection may develop because the contents of the pouch can get drawn into the lungs. If the pouch gets larger symptoms can get worse and the person could become malnourished. In a small number of patients, cancer can develop in the pouch.

The standard treatment for a pharyngeal pouch involves open surgery to the neck to remove the pouch. Endoscopic surgery is also used, dividing the wall between the pouch and the oesophagus by heat, lasers or staples. These techniques use a rigid endoscope. NICE has looked at using flexible endoscopic treatment of a pharyngeal pouch as another treatment option.