Patient‐Reported Swallowing Outcomes Following Open Repair of Pharyngeal Pouch: A Prospective Single‐Centre Observational Study

OBJECTIVE(S): To evaluate patient-reported swallowing outcomes and postoperative morbidity following open repair of pharyngeal pouch in a contemporary prospective cohort. DESIGN: Prospective single-centre observational study. SETTING: Tertiary referral otolaryngology unit. PARTICIPANTS: Twenty-three consecutive patients undergoing open repair of pharyngeal pouch between October 2023 and July 2025. The majority of patients (18/23, 78%) had undergone previous surgical intervention, including 17 who had undergone an endoscopic approach and 1 who had undergone an open approach. MAIN OUTCOME MEASURES: Swallowing-related quality of life measured using the M.D. Anderson Dysphagia Inventory (MDADI). Secondary outcomes included postoperative complications, length of hospital stay and postoperative morbidity. RESULTS: Twenty-three patients underwent open repair, with a mean postoperative follow-up of 3.8 months. Significant improvements were observed in patient-reported swallowing outcomes following surgery. Mean global MDADI scores improved from 2.04 ± 0.93 preoperatively to 4.48 ± 0.59 postoperatively (p < 0.001), while mean composite scores improved from 53.09 ± 13.64 to 86.09 ± 11.18 (p < 0.001). Eighteen patients (78%) achieved a clinically meaningful improvement of ≥ 20 points in composite score. The median length of hospital stay was 3 days (IQR 2-5 days). Four postoperative complications occurred, including two conservatively managed anastomotic leaks, one postoperative haemorrhage requiring return to theatre and one temporary unilateral vocal cord palsy. CONCLUSION: Open repair of pharyngeal pouch is associated with significant improvements in patient-reported swallowing outcomes and remains an important treatment option for selected patients, particularly those with recurrent disease or anatomy unsuitable for endoscopic treatment. Prospective assessment using the MDADI provides valuable insight into functional recovery following surgery.