{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T05:23:09Z","timestamp":1734067389125,"version":"3.30.2"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T00:00:00Z","timestamp":1723680000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The presence of a pseudodiverticulum of the anterior pharyngeal wall, or prominent \u201cpharyngeal bar,\u201d is a well\u2010known phenomenon that occurs following total laryngectomy, which can be visualized by nasolaryngoscopy or videofluoroscopy. Among the different techniques of pharyngeal reconstruction, there is higher incidence following primary vertical multilayered closure. It has been postulated to cause dysphagia and lack of dietary progression despite a paucity of data. However, the direct impact of pseudodiverticulum is less clear and anecdotally its presence and severity does not necessarily correlate with dysphagia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective case series was performed of all consecutive patients who underwent total laryngectomy or laryngopharyngectomy between 2015 and 2022 at two tertiary head and neck institutions. All patients underwent routine videofluoroscopy postoperatively for swallow assessment. The presence of pseudodiverticulum on postoperative contrast swallow study was recorded to investigate the relationship with patient's ability to tolerate oral intake at 3\u2009months discharge from the hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 50 laryngectomized patients (mean age 63.8\u2009\u00b1\u200910.0, 86% male), the main closure techniques were primary vertical (<jats:italic>n<\/jats:italic>\u2009=\u20099, 18%), primary T\u2010closure (<jats:italic>n<\/jats:italic>\u2009=\u200914, 28%), and flap reconstruction (<jats:italic>n<\/jats:italic>\u2009=\u200927, 54%). Pseudodiverticulum was identified in 19 cases (38%). 43 patients underwent primary surgery and 30 had adjuvant radiotherapy. The presence of pseudodiverticulum was significantly associated with vertical primary closure versus non\u2010vertical (T\u2010closure or flap reconstruction) techniques (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> (df 1)\u2009=\u20097.4, <jats:italic>p<\/jats:italic>\u2009=\u20090.007, OR\u2009=\u20095.7, 95% CI 1.3\u201324.7). Pseudodiverticulum was not associated with an increased inability to tolerate solid intake or full diet compared to patients without pseudodiverticulum. 26.3% of patients with pseudodiverticulum were on full diet compared to 25.8% of patients without. The vertical closure technique showed no difference in ability to maintain solid intake compared with non\u2010vertical closure; however, no patients were on full diet. Only one patient in the pseudodiverticulum group required surgical management during the study period for retention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The presence of a pseudodiverticulum does not appear to be significantly associated with a need for postoperative dietary modification. The authors postulate that postlaryngectomy dysphagia is multifactorial with sensorimotor aperistalsis of the pharynx and cricopharyngeal stenosis. While a pseudodiverticulum is a common phenomenon, patients did not require modification of diet at higher rates than those without, and they seldom require intervention.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27921","type":"journal-article","created":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T07:09:05Z","timestamp":1723705745000},"page":"309-316","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Presence of postlaryngectomy pseudodiverticulum on barium swallow does not affect early dietary progression"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5080-9284","authenticated-orcid":false,"given":"Saikrishna","family":"Ananthapadmanabhan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Westmead Hospital  Westmead New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5799-5083","authenticated-orcid":false,"given":"Eugene","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Westmead Hospital  Westmead New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lydia","family":"Natsis","sequence":"additional","affiliation":[{"name":"Department of Speech Pathology Westmead Hospital  Westmead New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anand","family":"Suruliraj","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Westmead Hospital  Westmead New South Wales Australia"},{"name":"Department of Otolaryngology Nepean Hospital  Nepean New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niranjan","family":"Sritharan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Westmead Hospital  Westmead New South Wales Australia"},{"name":"Department of Otolaryngology Nepean Hospital  Nepean New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Westmead Hospital  Westmead New South Wales Australia"},{"name":"Department of Otolaryngology Nepean Hospital  Nepean New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten E.","family":"Palme","sequence":"additional","affiliation":[{"name":"Chris O'Brien Lifehouse  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faruque","family":"Riffat","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Westmead Hospital  Westmead New South Wales Australia"},{"name":"Department of Otolaryngology Nepean Hospital  Nepean New South Wales Australia"},{"name":"Chris O'Brien Lifehouse  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,15]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"2135","volume-title":"Cummings Otolaryngology","author":"Rassekh C","year":"2020"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.94191"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.18181"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537\u2010198201000\u201000004"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/363640"},{"issue":"85","key":"e_1_2_9_7_1","first-page":"141","article-title":"Evaluation of post laryngectomy pharyngocutaneous fistula risk factors","volume":"28","author":"Nitassi S","year":"2016","journal-title":"Iran J Otorhinolaryngol"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010016\u20104424\u20104"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12905"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116000621"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537\u2010199604000\u201000018"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.430"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1962.00740040050003"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010004\u20100015\u20104"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0022215100147498"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0899\u20107071(98)00032\u20101"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001060050198"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537\u2010196301000\u201000002"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2880120614"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030\u20106657(10)70023\u20108"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599810390906"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27311"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25508"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.5604\/01.3001.0014.5705"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145561318097004\u2010502"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348948008900301"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1258\/0022215011908865"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194\u20105998(96)70158\u20104"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2011.08.013"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/4015201"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215117001712"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1053\/hn.1999.v121.a94213"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002221510012715X"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1055\/a\u20101824\u20104546"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.27921","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T10:59:04Z","timestamp":1734001144000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.27921"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,15]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/hed.27921"],"URL":"https:\/\/doi.org\/10.1002\/hed.27921","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"type":"print","value":"1043-3074"},{"type":"electronic","value":"1097-0347"}],"subject":[],"published":{"date-parts":[[2024,8,15]]},"assertion":[{"value":"2024-02-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}