Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls
CPT4 code
Name of the Procedure:
Resection of Lateral Pharyngeal Wall or Pyriform Sinus with Direct Closure by Advancement of Lateral and Posterior Pharyngeal Walls
Summary
This surgical procedure involves removing a part of the lateral pharyngeal wall or pyriform sinus and then closing the surgical area by advancing the lateral and posterior walls of the pharynx. This helps restore normal function and structure following the removal of abnormal tissue.
Purpose
The procedure addresses the removal of abnormal growths or cancers within the lateral pharyngeal wall or pyriform sinus. The goals are to eliminate the pathological tissue, restore normal anatomy, and maintain pharyngeal function.
Indications
- Presence of benign or malignant tumors in the lateral pharyngeal wall or pyriform sinus.
- Persistent or recurrent infections.
- Obstruction causing difficulty in swallowing or breathing.
- Patients who have been evaluated and found to have resectable lesions.
Preparation
- The patient will need to fast for at least 8 hours before the procedure.
- Anticoagulant medications may need to be adjusted or paused.
- Preoperative imaging studies, such as CT or MRI scans, are performed to plan the surgery.
- A thorough evaluation by an anesthesiologist will be conducted to assess the patient's suitability for anesthesia.
Procedure Description
- The patient is placed under general anesthesia.
- The surgeon makes an incision to access the lateral pharyngeal wall or pyriform sinus.
- The abnormal tissue is carefully resected using surgical tools.
- The lateral and posterior walls of the pharynx are advanced to cover the resected area and sutured together.
- Hemostasis is achieved, and the incision is closed.
Tools and Equipment:
- Scalpels, retractors, sutures
- Electrocoagulation devices to control bleeding
Duration
The duration of the procedure typically ranges from 2 to 4 hours, depending on the extent of the resection.
Setting
The procedure is performed in a hospital operating room.
Personnel
- Head and neck surgeon
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Bleeding
- Infection
- Difficulty swallowing or aspiration
- Nerve injury leading to changes in voice or sensation
- Anesthetic complications
- Scarring and stenosis
Benefits
- Removal of pathological tissue
- Restoration of normal swallowing and breathing function
- Potentially life-saving in cases of malignant tumors
Benefits may be realized gradually over weeks to months after surgery.
Recovery
- Hospital stay for 3 to 7 days post-surgery.
- Pain management with prescribed medications.
- Gradual reintroduction of oral intake from liquids to solids.
- Follow-up appointments to monitor healing and address any complications.
Expected recovery time is 4 to 6 weeks, with restrictions on heavy lifting and strenuous activities.
Alternatives
- Radiation therapy or chemoradiation for inoperable tumors.
- Less invasive endoscopic resections for suitable lesions.
- Opinion on benefits and risks varies; alternatives may provide different outcomes regarding tumor control and impact on quality of life.
Patient Experience
- The patient will be under general anesthesia and not feel anything during the procedure.
- Postoperative discomfort and pain managed with medication.
- Sore throat and difficulty swallowing immediately after surgery.
- Emotional support and brief periods of rehabilitation may be necessary for full recovery.