Zenker's diverticulum or pharyngeal pouch is a herniation of pharyngeal mucosa through a defect located on the posterior pharyngeal wall, in an area of natural weakness between the 2 parts of the inferior constrictor muscles. The incidence of presentation of pharyngeal pouch to an ear, nose, throat (ENT) specialist was estimated as 0.47 cases per 100,000 per year. It could be a rare cause of dysphagia in elderly patients, associated with regurgitation, chronic cough, aspiration, and weight loss. The etiology still unknown, but theories focus upon structural or physiological disorders of the cricopharyngeus muscle. Zenker's diverticulum should be considered as one of the rare causes of dysphagia in elderly patients, and the treatment modalities depend on individual experience and availability of the facilities.
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An Atypical Zenker's Diverticulum: A Case Report.
Cureus
December 2024
Medical Speciality Department, Niger Maradi Reference Hospital, Maradi, NER.
A Zenker's diverticulum (ZD) is an acquired hernia of the mucosa and submucosa at the pharyngoesophageal junction dorsally through Killian's triangle, considered a zone of weakness. The authors report their experience in the management of a case of a ZD with oral externalization following coughing. Surgery made by a multidisciplinary team consisted first of resection of the edematous exteriorized portion of the diverticulum.
View Article and Find Full Text PDFPeroral endoscopic myotomy (Z-POEM) versus flexible endoscopic septotomy (FES) for treatment of Zenker's diverticulum: does either make the cut? A systematic review and meta-analysis of outcomes.
Ann Gastroenterol
December 2024
Center for Interventional Endoscopy (CIE), Advent Health, Orlando, FL, USA (Saurabh Chandan, Dennis Yang).
Background: Endoscopic treatments of symptomatic Zenker's diverticulum (ZD) include flexible endoscopic septotomy (FES) and, more recently, peroral endoscopic myotomy (Z-POEM). Data comparing these techniques are limited. We conducted a meta-analysis evaluating FES vs.
View Article and Find Full Text PDFThe A to Z of Peroral Endoscopic Myotomy.
J Clin Gastroenterol
February 2025
Digestive Disease and Surgery Institute, Cleveland Clinic London, UK.
Peroral endoscopic myotomy (POEM) is a novel technique within the field of third space endoscopy. The overarching principal is creation of a mucosal incision, careful dissection of the submucosal space using an electrosurgical knife to reach the muscularis (ie, tunneling), performing a controlled myotomy, and finally, closure of the mucosal incision. POEM was first developed for the management of achalasia, and now a decade of evidence shows the procedure is safe, effective, and highly reproducible.
View Article and Find Full Text PDFComplications Following Surgical Management of Zenker Diverticulum: A Comparative Analysis of Endoscopic and Open Approaches.
Otolaryngol Head Neck Surg
January 2025
Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Objective: We aim to explore the differences in complication rates in endoscopic versus open transcervical treatment of Zenker diverticulum.
Study Design: Retrospective Cohort Study from January 1, 2015 to December 31, 2023.
Setting: Queries of the TriNetX database's United States Collaborative Network.
Flexible endoscopic treatment of Zenker's diverticulum: a retrospective study in a single center from Turkey.
Clin Endosc
December 2024
Department of Gastroenterology, Ankara Bilkent City Hospital, Ankara, Turkiye.
Article Synopsis
- The study focused on patients with Zenker's diverticulum who were treated using cricopharyngeal myotomy with flexible endoscopic septal division.
- A total of 15 patients underwent this procedure, with a reported clinical success rate of 80%, although 20% experienced a return of symptoms.
- The findings suggest that despite new techniques in endoscopy, traditional cricopharyngeal myotomy is still an effective treatment for this condition.
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