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Dysphagia 2020 Jun 19. Epub 2020 Jun 19.

Radiology Department, Russells Hall Hospital, Dudley, UK.

Although barium swallow imaging is established in the investigation of Zenker's diverticulum (ZD), no agreed measurement protocol exists. We developed a protocol for measuring ZD dimensions and aimed to correlate measurements with symptoms and post-operative outcomes. This prospective study included patients with confirmed ZD who underwent flexible endoscopic septal division (FESD) between 2014 and 2018. Read More

Int J Surg Case Rep 2020 29;71:274-276. Epub 2020 May 29.

Kscien Organization for Scientific Research, Hamdi Street, Sulaimani, Kurdistan, Iraq.

Introduction: Zenker's diverticulum is an acquired mucosal pulsion of the upper esophagus. The aim of this paper is to report a case of Zenker's diverticulum with a complicated postoperative course including infection by Acinetobacter baumannii causing diagnostic as well as management dilemma.

Case Report: A 43-year-old male complained from dysphagia for three months. Read More

VideoGIE 2020 May 11;5(5):187-189. Epub 2020 Feb 11.

Division of Digestive Diseases and Division of Cardiology, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.

Dis Esophagus 2020 Apr 8. Epub 2020 Apr 8.

Department of Interdisciplinary Endoscopy, University Hospital Mainz, Mainz, Germany.

Objectives: Flexible endoscopic septum division is an established treatment for Zenker's diverticulum (ZD); however, long-term outcome data are lacking. We aimed to evaluate the long-term efficacy of flexible endoscopic septal division (FESD) using the stag beetle knife for ZD and identify predictors of symptom recurrence.

Methods: Patients undergoing the procedure between 2013 and 2018 were prospectively enrolled. Read More

GE Port J Gastroenterol 2020 Feb 30;27(2):132-134. Epub 2019 Jul 30.

Gastroenterology Department, Hospital do Divino Espírito Santo de Ponta Delgada, Ponta Delgada, Portugal.

Am J Otolaryngol 2020 May - Jun;41(3):102453. Epub 2020 Mar 10.

Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, USA. Electronic address:

Objectives: Nasogastric tubes (NGT) are often placed after surgery for cricopharyngeal muscle pathology due to risk of infection and mediastinitis. The aim of this study was to examine if this practice is necessary.

Methods: A retrospective case series of subjects who underwent surgery for hypopharyngeal diverticula or cricopharyngeal bars from March 2011 to June 2018 was conducted. Read More

Internist (Berl) 2020 Apr;61(4):411-415

Abteilung für Geriatrie, Zentrum für Allgemeinmedizin und Geriatrie, Universitätsmedizin Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.

Pneumonia and in particular aspiration pneumonia, is a common disease in geriatrics. These aspirations are often due to dysphagia, which is frequently first noticed in the context of a geriatric assessment. The reasons for dysphagia are manifold. Read More

Medicine (Baltimore) 2020 Jan;99(5):e18659

Department of Gastroenterology, Ningbo First Hospital, Ningbo.

Introduction: Zenker's diverticulum (ZD) refers to a pouch-like structure similar to the esophageal lumen formed from the herniation of the esophageal mucosa; this structure makes it difficult for food to pass through the esophagus to the stomach. The development of endoscopic technology has made minimally invasive surgical treatments for ZD possible.

Patient Concerns: A female 72-year-old patient was admitted to our hospital due to recurrent dysphagia for more than 5 years. Read More

Gastrointest Endosc 2020 01;91(1):205-206

Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA.

Gastrointest Endosc 2020 01;91(1):204-205

Department of Interdisciplinary Endoscopy, University Hospital Mainz, Mainz, Germany.

Gastrointest Endosc 2020 01;91(1):169-171

Division of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, Florida, USA.

Laryngoscope 2019 Dec 19. Epub 2019 Dec 19.

Department of Otolaryngology-Head & Neck Surgery, Medical College of Georgia at Augusta University, Augusta, GA, U.S.A.

J Clin Gastroenterol 2020 Feb;54(2):114-129

Shivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Pune, Maharashtra, India.

The field of third space endoscopy (TSE), also called submucosal endoscopy using a mucosal flap valve, allows secure access to the submucosal and deeper layers of the gastrointestinal tract without the risk of a full-thickness perforation. Since the first description of per-oral endoscopic myotomy (POEM) for the treatment of achalasia cardia 10 years ago, this field has expanded rapidly. Several new procedures, submucosal tunneling endoscopic resection, gastric-POEM, Zenker POEM, per-rectal endoscopic myotomy, diverticular POEM, and recanalization for complete esophageal obstruction (per-oral endoscopic tunneling for restoration of the esophagus), have been performed. Read More

VideoGIE 2019 Dec 19;4(12):551-553. Epub 2019 Oct 19.

Department of Internal Medicine, Division of Gastroenterology, Michigan Medicine, Ann Arbor, Michigan, USA.

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2019 Aug;27(Special Issue):721-728

A. S. Loginov City Clinical Scientific Centre, 111123, Moscow, Russia,

Endoscopic treatment methods are currently a priority in the treatment of patients with Zenker's diverticulum. The optimal endoscopy should combine the positive aspects of traditional and tunnel technologies and be fairly simple from technical standpoint, the most radical and safe for the patient. This work evaluates the effectiveness of endoscopic cricopharyngeal esophagomyotomy using combined methods of treating patients with Zenker's diverticulum. Read More

Am J Otolaryngol 2020 Jan - Feb;41(1):102325. Epub 2019 Oct 25.

Division of Otolaryngology, Department of Surgery, University of California San Diego, La Jolla, CA, United States of America. Electronic address:

Objectives: The objective of this study is to analyze and report the institution's experience using the Enseal bipolar tissue sealing device to perform endoscopic Zenker's diverticulotomy. Safety and early functional outcomes are presented as primary endpoints of the study.

Materials & Methods: This is a retrospective study of consecutive patients with Zenker's diverticulum (ZD) treated via a transoral approach using a rigid endoscope and a bipolar tissue sealer between 2011 and 2019. Read More

Ann Otol Rhinol Laryngol 2020 Apr 9;129(4):394-400. Epub 2019 Nov 9.

Department of Otolaryngology/Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.

Objective: To examine the clinical presentation, diagnostic evaluation, and management of Killian-Jamieson diverticula (KJD) through literature review.

Methods: A comprehensive literature review was conducted through December 2018 using keywords Killian-Jamieson diverticula/diverticulum. Data extracted included clinical presentation, imaging characteristics, surgical management, and postoperative care. Read More

J Gastroenterol Hepatol 2020 Apr 9;35(4):630-633. Epub 2019 Dec 9.

Department of Gastroenterology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.

Background And Aim: Zenker's diverticulum (ZD) is the most common type of diverticulum in the esophagus. The endoscopic septotomy of the diverticular wall has become a widely accepted treatment modality, but the recurrence rate is unclear. Our aim was to assess short-term and long-term success rates after flexible endoscopic septotomy for the treatment of ZD. Read More

Endoscopy 2019 12 21;51(12):1141-1145. Epub 2019 Oct 21.

Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Background: Symptomatic epiphrenic diverticula are mostly treated with laparoscopic diverticulectomy. Our study aimed to demonstrate the safety and efficacy of submucosal tunneling endoscopic septum division (STESD) for treatment of symptomatic epiphrenic diverticula.

Methods: Data from patients with epiphrenic diverticula who had undergone STESD were retrospectively reviewed. Read More

Endoscopy 2019 12 15;51(12):1136-1140. Epub 2019 Oct 15.

Baldota Institute of Digestive Sciences, Global Hospitals, Mumbai, Maharashtra, India.

Background: Submucosal tunneling diverticular septotomy by diverticular peroral endoscopic myotomy (D-POEM) has emerged as an alternative to surgery for symptomatic esophageal diverticula, but its medium to long-term outcomes are currently unexplored.

Methods: D-POEM for patients with symptomatic esophageal diverticula was prospectively studied to assess its safety and the 12-month outcomes.

Results: 25 patients (72 % male; median age 61 years [range 48 - 88]) with a Zenker's diverticulum (n = 20) or epiphrenic diverticulum (n = 5) were included. Read More

Laryngoscope 2020 Jun 28;130(6):1383-1387. Epub 2019 Aug 28.

Center for Voice and Swallowing, Department of Otolaryngology-Head & Neck Surgery, University of California Davis, Sacramento, California.

Objectives: A Zenker's diverticulum (ZD) is a hypopharyngeal pulsion diverticula caused by dysfunction of the cricopharyngeus muscle with herniation of hypopharyngeal mucosa through Killian's dehiscence. Anterior cervical spine surgery (ACSS) can cause a Zenker's-like traction diverticulum (ZTD) with a similar presentation but different pathophysiology. The purpose of this investigation was to compare the fluoroscopic parameters and surgical outcomes of ZTD after ACSS to those of typical ZD. Read More

Lancet Gastroenterol Hepatol 2019 09;4(9):742

Department of Otorhinolaryngology & Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.

Case Rep Gastrointest Med 2019 16;2019:9621383. Epub 2019 Jul 16.

Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.

Background: Dentures are a common cause of inadvertent foreign body ingestion particularly in the elderly. Due to their radiolucent nature, they often present a diagnostic challenge to care providing physicians.

Case Presentation: A 66-year-old female presented to our otolaryngology clinic with a 2-year history of dysphagia. Read More

Otolaryngol Head Neck Surg 2019 11 30;161(5):906-908. Epub 2019 Jul 30.

Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, California, USA.

The surgical management of Zenker's diverticula is performed through open or endoscopic approaches. The purpose of this report is to review our early experience with flexible endoscopic diverticulotomy with an articulating bipolar energy sealer for cricopharyngeal and diverticular wall division in a series of 5 patients where transoral rigid access was not possible. In addition to technical details, safety and efficacy data are included. Read More

J Laryngol Otol 2019 06;133(6):449

Dysphagia 2019 10 22;34(5):713-715. Epub 2019 Jun 22.

Department of Surgery (Section of Otolaryngology), Yale University School of Medicine, New Haven, CT, USA.

The etiopathogenesis of Zenker's diverticulum (ZD) remains uncertain. Increased hypopharyngeal pressure due to a hypertonic upper esophageal sphincter results in herniation proximal to the sphincter producing a pulsion diverticulum. Gastroesophageal reflux, which is known to induce shortening of the injured esophagus, likely plays a prominent role in ZD formation by pulling the cricopharyngeus muscle (CPM) away from the anchored inferior constrictor muscle. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2020 Jan 6;137(1):61-63. Epub 2019 Jun 6.

Institut universitaire de la face et du cou, 31, avenue de Valombrose, 06103 Nice, France.

Introduction: Dysphagia is a common presenting complaint and can often be due to pharyngoesophageal diverticulum, including Zenker's diverticulum. Iatrogenic pharyngeal diverticulum, occurring after anterior cervical spine surgery, is a rare cause of dysphagia.

Case Report: We report the case of a 51-year-old man, with a history of anterior cervical fusion about ten years previously, who complained of chronic dysphagia and disabling episodes of aspiration. Read More

Diagn Cytopathol 2019 Aug 3;47(8):843-844. Epub 2019 Jun 3.

Prof. Eleutério Laboratory, Fortaleza, Brazil.

J Laryngol Otol 2019 Jun 3;133(6):515-519. Epub 2019 Jun 3.

Department of Otorhinolaryngology,Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand,Johannesburg,South Africa.

Background: Zenker's diverticulum is a pharyngoesophageal outpouching of mucosa and submucosa through Killian's dehiscence.

Objective: To investigate the propensity for Zenker's diverticulum to occur on the left side by examining muscle thickness in Killian's dehiscence, and to explore correlations between muscle thickness, sex, height and age.

Methods: The study included 109 Caucasian cadavers, 52 male and 57 female. Read More

Endoscopy 2019 09 9;51(9):E259-E260. Epub 2019 May 9.

Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Rozzano, Milan, Italy.

Endoscopy 2019 08 2;51(8):E231-E232. Epub 2019 May 2.

Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, USA.

Laryngoscope 2020 Mar 25;130(3):637-640. Epub 2019 Apr 25.

Department of Surgical, Oncological and Gastrointestinal Sciences, University of Padova, Clinica Chirurgica 3, Padova, Italy.

Objective: Transoral diverticulostomy/septotomy has become a popular treatment for patients with Zenker diverticulum (ZD). To improve the results of transoral stapler-assisted septotomy, a modification of the technique has been introduced. In this study, we aimed to compare the final outcome of such a modified transoral septotomy (MTS) with the results of traditional transoral septotomy (TTS) in patients with ZD. Read More

Otolaryngol Head Neck Surg 2019 09 23;161(3):388-400. Epub 2019 Apr 23.

12 San Diego Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego, California, USA.

Objective: To determine adverse events after endoscopic flexible vs endoscopic rigid cricopharyngeal myotomy for treatment of Zenker's diverticulum (ZD).

Data Sources: Systematic review of MEDLINE, Web of Science, CINAHL, Clinicaltrials.gov, and Cochrane Central Register of Controlled Trials for all years according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Read More

Orv Hetil 2019 Apr;160(16):629-635

Sebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Semmelweis u. 8., 6720.

Introduction And Aim: We present our experience with open (transcervical diverticulectomy, cricomyotomy) and transoral surgery (transoral stapler diverticulostomy) for Zenker diverticulums.

Method: Between 1 January 2006 and 31 December 2016, 29 patients were examined with a symptom-causing Zenker diverticulum. In 13 cases, transcervical surgery, in 16 cases, transoral surgery were performed. Read More

Am Surg 2019 Mar;85(3):284-287

Two of the accepted treatments for symptomatic Zenker's diverticula are open resection of the diverticulum with cricopharyngotomy and transoral, endoscopic diverticuloesophagostomy with cricopharyngotomy. We report our experience with open surgical resection of the diverticulum with repeat cricopharyngotomy in patients with persistent symptoms after endoscopic diverticuloesophagostomy. This is a retrospective review of patients who underwent open surgical resection of the diverticulum, with repeat cricopharyngotomy in patients with persistent symptoms after endoscopic diverticuloesophagostomy. Read More

Gastrointest Endosc 2019 04;89(4):887-888

Gastroenterology Department, São Paulo University Medical School, São Paulo, Brazil.

Eur Arch Otorhinolaryngol 2019 May 15;276(5):1423-1429. Epub 2019 Mar 15.

Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.

Purpose: Transoral resection of Zenker's diverticulum (TORD) was first reported in 2010. We present results for our modified approach to transoral resection (MTORD)-full-thickness cricopharyngeal myectomy, diverticulum sac excision, and suture closure of the pharyngotomy-and evaluate its safety and efficacy compared to endoscopic stapling and open approaches.

Methods: A retrospective study was performed in patients who underwent transoral resection of Zenker's diverticulum using MTORD, endoscopic stapler-assisted diverticulotomy (ESD), or trancervical diverticulectomy (TCD) from July 2009 to August 2017. Read More

Dysphagia 2019 12 12;34(6):930-938. Epub 2019 Mar 12.

Department of Otolaryngology Head and Neck Surgery, University of Cincinnati, Cincinnati, OH, USA.

Most Zenker's diverticula (ZD) cohort studies are single-institution retrospective observational studies of recurrence rates. There is a gap in the literature regarding patient-reported outcomes after ZD surgery. This study was conducted to compare if open transcervical diverticulectomy (OD) is better than endoscopic laser diverticulectomy (ELD) or endoscopic stapler-assisted diverticulectomy (ESD). Read More

Gastroenterology 2019 06 7;156(8):2134-2135. Epub 2019 Mar 7.

Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland. Electronic address:

Rev Esp Enferm Dig 2019 May;111(5):378-383

Hospital Universitari i Politècnic La Fe.

Background And Objectives: endoscopic septotomy of the cricopharyngeal muscle (ESCM) is a technique used for the treatment of Zenker's diverticulum (ZD). The experience with computerized vascular sealing systems (LigaSure® type) is limited. The objective of this study was to evaluate the efficacy and safety of ESCM using LigaSure®. Read More

Dig Endosc 2019 May 14;31(3):e78-e79. Epub 2019 Apr 14.

Gastroenterology Department, Dudley Group Hospitals, Birmingham City University, Birmingham, UK.

Acta Otorhinolaryngol Ital 2019 Aug 31;39(4):230-234. Epub 2019 Jan 31.

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany.

Orv Hetil 2019 Feb;160(7):264-269

Sebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged.

Microscope-assisted direct endoscopy of the airways and the upper gastrointestinal tract in general anesthesia is an essential diagnostic and therapeutic method of otorhinolaryngology. The quality of surgical exploration is a key for the good visibility and maneuverability of microsurgical tools. Beside the most commonly used Kleinsasser laryngoscope, the distending Weerda laryngoscope is a more favorable option for the exploration of the retrocricoid region. Read More

Endoscopy 2019 04 7;51(4):E79-E80. Epub 2019 Feb 7.

Department of Endoscopy and Gastroenterology, Pavillon L, Edouard Herriot Hospital, Lyon, France.

J Laryngol Otol 2019 Feb 6;133(2):125-128. Epub 2019 Feb 6.

Department of ENT,Doncaster Royal Infirmary,UK.

Background: Pharyngeal pouch surgical treatments can be carried out via an endoscopic or open approach. Injection of botulinum toxin into the cricopharyngeus was first described as an alternative treatment to the more invasive surgical procedures performed for cricopharyngeal dysfunction. It has not been previously described as a treatment option for pharyngeal pouch. Read More

J Gastroenterol Hepatol 2019 08 4;34(8):1272. Epub 2019 Feb 4.

Division of Gastroenterology, Niigata University Medical and Dental Hospital, Japan.

Endoscopy 2019 03 11;51(3):E63-E64. Epub 2019 Jan 11.

Department of Gastroenterology, Hepatology, and Nutrition, University of Texas MD Anderson Cancer Center, Houston, Texas, United States.

Diagn Cytopathol 2019 May 10;47(5):503-506. Epub 2019 Jan 10.

Department of Radiology, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.

Pharyngeal or Zenker's diverticulum is an infrequent disorder that results from an outpouching of pharyngeal mucosa through a weakened area in the posterior pharyngeal wall. As it may mimic a thyroid nodule on ultrasonography (US), accurate diagnosis is important to ensure appropriate treatment. Fine-needle aspiration (FNA) is recommended for the initial evaluation of thyroid nodules. Read More

BMJ Case Rep 2018 Dec 9;11(1). Epub 2018 Dec 9.

Neurosurgery, Ospedali Riuniti di Ancona, Università Politecnica delle Marche, Ancona, Italy.

We present a case of Zenker's diverticulum in a 45-year-old woman, occurred as complication after anterior cervical discectomy and fusion for a cervical spine injury. The oesophageal complication occurred 12 months after vertebral cervical surgery and presenting symptoms were fever, dysphagia and neck pain with evidence of retropharyngeal infection. We performed a posterior cervical stabilisation C3-D1 by screws and rods and a second anterior left cervical approach with anterior plate removing and oesophageal wall break repairing with a sternohyoid muscle patch. Read More