A case report of bilateral pharyngoceles without a history of elevated intrapharyngeal pressures is used to support the hypothesis that pharyngoceles may be an adult manifestation of an internal branchial sinus anomaly. The development of a pharyngocele from a branchial sinus origin would suggest a predictable relationship to the hypoglossal, glossopharyngeal, and superior laryngeal nerves, which may influence the choice of surgical approach (open versus endoscopic) and the counseling of patients who are considering surgical correction.
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ListonSL. Fourth branchial fistula. Otolaryngol Head Neck Surg1981; 89: 520–2.
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ChangCYPayyapilliRJScherRL. Endscopic staple diverticulostomy for Zenker's diverticulum: Review of literature and experience in 159 consecutive patients. Laryngoscope2003; 113: 957–65.