Lateral pharyngeal diverticulum as a cause of superior laryngeal nerve neuralgia

Superior laryngeal neuralgia was first described at the turn of the century by Avellis. In absence of accompanying disease in the organs adjacent to the nerve, idiopathic neuralgia is the most likely diagnosis. A 63-year-old man presented with left superior laryngeal neuralgia. Endoscopy revealed no pathological findings. Barium examination of the pharynx applying a modified Valsalva's manoeuvre revealed a small (0.5 cm) lateral pharyngeal diverticulum. 21 months after successful surgical removal the patient remains symptom-free. In the case of a 65-year old woman with left superior laryngeal neuralgia, barium examination revealed a lateral pharyngeal diverticulum at the same position between the hyoid-bone and the upper margin of the thyroid cartilage. The symptoms disappeared spontaneously. This is the first case of this particular kind of lateral pharyngeal diverticulum described in the literature. The explanation for the obstinate superior laryngeal neuralgia caused by such a small diverticulum must be sought in its immediate neighborhood to the superior laryngeal nerve.