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Laryngoscope 2021 May 10. Epub 2021 May 10.

Department of Otolaryngology-Head and Neck Surgery, University of Washington Medical Center, Seattle, Washington, U.S.A.

Objectives/hypothesis: To evaluate the clinical utility of postoperative contrast x-ray pharyngograms (XRP) for detecting pharyngoesophageal leaks following hypopharyngeal dysphagia surgery.

Study Design: Retrospective cohort study.

Methods: Medical records were reviewed of patients undergoing endoscopic (E-) or open (O-) Zenker's diverticulectomy (-ZD) with cricopharyngeal myotomy (-CPM) and CPM alone from 2008 to 2020 at one academic institution. Read More

Dtsch Med Wochenschr 2021 Apr 30;146(9):608-612. Epub 2021 Apr 30.

Klinik für Gastroenterologie, Gastroenterologische Tumortherapie und Diabetologie, Gemeinschaftsklinikum Mittelrhein, Kemperhof, Koblenz.

Since the first publication of peroral endoscopic myotomy (POEM) by Haruhiro Inoue et al. in 2008 in Japan, various novel endoscopic procedures have been established, which are performed after iatrogenic creation of a submucosal tunnel as a "new space" 1. Through the artificially formed access in the tela submucosa, interventions in the muscular layer of the esophagus and stomach can be performed while carefully sparing the mucosal layer 2. Read More

J Community Hosp Intern Med Perspect 2021 Mar 23;11(2):228-234. Epub 2021 Mar 23.

Department of Radiology, SKMC at Thomas Jefferson University, Philadelphia, PA, USA.

A Killian-Jamieson diverticulum is a 'false' diverticulum on the lateral side of the proximal cervical esophagus. They are much rarer than Zenker diverticula and can be difficult to diagnose. They are best visualized using fluoroscopy studies, however, the workup for patients admitted with dysphagia can be sometimes extensive and unnecessary, leading to costly hospital stays, longer admissions and exposure to excessive radiation. Read More

Endoscopy 2021 04 29;53(4):456. Epub 2021 Mar 29.

Division of Gastroenterology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

Endoscopy 2021 04 29;53(4):455. Epub 2021 Mar 29.

Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Endoscopy 2021 04 29;53(4):354-356. Epub 2021 Mar 29.

Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, Arizona, United States.

Khirurgiia (Mosk) 2021 (3):57-61

Petrovsky National Research Center of Surgery, Moscow, Russia.

We evaluated the possibility and effectiveness of transaxillary gas-free approach for minimally invasive Zenker's diverticulectomy. A 64-year-old patient with large Zenker's diverticulum (6 cm) and pathognomonic symptoms is presented. Transaxillary gas-free minimally invasive diverticulectomy was performed using an endoscopic linear stapler. Read More

Surg Laparosc Endosc Percutan Tech 2021 Mar 12. Epub 2021 Mar 12.

Departments of Gastroenterology Radiodiagnosis Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Introduction: The modification of NOTES (natural orifice transluminal endoscopic surgery) by mucosal safety flap has introduced us to the world of third space endoscopy (TSE). POEM (per-oral endoscopic myotomy) for achalasia cardia being its first vista, the realm expanded so that we can now remove en bloc a subepithelial/intramural tumor by POET (per-oral endoscopic tumor resection), perform G-POEM (gastric per-oral endoscopic myotomy) for refractory gastroparesis, restore esophageal continuity in complete obstruction by performing POETRE (per-oral endoscopic tunneling for the restoration of the esophagus), divide the septum in Zenker diverticulum completely with negligible risk of perforation by Z-POEM (Zenker per-oral endoscopic myotomy) and relieve constipation in Hirschsprung disease by PREM (per-rectal endoscopic myotomy). However, the real potential of TSE became evident with the introduction of POEM with fundoplication. Read More

J Laryngol Otol 2021 03 1;135(3):280. Epub 2021 Mar 1.

Department of Gastroenterology, Dudley Group NHS Foundation Trust, West Midlands, UK.

Internist (Berl) 2021 Mar 9;62(3):277-287. Epub 2021 Feb 9.

Medizinische Klinik II, Klinik für Innere Medizin mit Gastroenterologie, Hepatologie, Infektiologie, Neurogastroenterologie, Gastrointestinaler Onkologie, Hämatoonkologie und Palliativmedizin, Helios Klinikum Krefeld, Lutherplatz 40, 47805, Krefeld, Deutschland.

The prevalence of diverticula varies depending on the location within the gastrointestinal tract. Diverticula of the esophagus, stomach and small intestine are rare, more frequent are peripapillary diverticula and colonic diverticula. Meckel diverticula can also be of relevance in adults. Read More

Acta Otorrinolaringol Esp (Engl Ed) 2021 Jan 19. Epub 2021 Jan 19.

Servicio de Otorrinolaringología, Hospital Universitario de Cabueñes, Gijón, España.

Introduction: Zenker's diverticulum is an uncommon pathology of the upper oesophageal sphincter whose most frequent symptoms are the association of dysphagia and regurgitation. It is more frequent in advanced ages, and its treatment of choice is surgery in symptomatic cases.

Method: A retrospective descriptive study was performed of 27 patients operated in the Otorhinolaryngology service of the Hospital Universitario de Cabueñes between 2007 and 2019 using laser endoscopic surgery. Read More

Pan Afr Med J 2020 5;37:121. Epub 2020 Oct 5.

Service de Néphrologie de l´Hôpital Aristide Le Dantec, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal.

Zenker's diverticulum is a rare and generally benign condition. Its occurrence in a hemodialysis patient has therapeutic and prognostic implications and is a risk factor for mortality and morbidity due to its complications, such as protein-energy malnutrition and pneumonitis. We here report a case of Zenker's diverticulum diagnosed in a chronic haemodialysis patient. Read More

Ann Med Surg (Lond) 2020 Dec 6;60:515-517. Epub 2020 Nov 6.

Oxford University Hospitals, NHS Foundation Trust, United Kingdom.

We discuss an unusual presentation of Zenker's Diverticulum (ZD). A 76-year-old man presented with a left sided neck mass which was misdiagnosed as a thyroid mass due to the anatomical location and size. The ultrasound and fine needle-aspiration cytology findings were inconclusive, and a CT scan was then considered which reported a large pharyngeal pouch. Read More

JAMA Otolaryngol Head Neck Surg 2021 02;147(2):190-196

Department of Otolaryngology-Head and Neck Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri.

Importance: Zenker diverticulum (ZD) can cause significant dysphagia, and symptoms can return or persist after surgery. This systematic review and network meta-analysis is the first to our knowledge to compare 3 common surgical techniques for ZD.

Objective: To compare the 3 most common surgical techniques-endoscopic laser-assisted diverticulotomy, endoscopic stapler-assisted diverticulotomy, and transcervical diverticulectomy with cricopharyngeal myotomy-in adult patients with ZD. Read More

BMJ Case Rep 2020 Nov 30;13(11). Epub 2020 Nov 30.

ENT, Leicester Royal Infirmary, Leicester, UK.

Endoscopic stapling is the preferred technique for treatment of symptomatic pharyngeal pouches. The use of stapling with a standard pharyngoscope can be successful in difficult access patients. This modification of the technique can prevent the conversion of an endoscopic approach to an open approach. Read More

Am J Otolaryngol 2021 Jan - Feb;42(1):102774. Epub 2020 Oct 27.

Division of Otolaryngology, Department of Surgery, University of California San Diego, United States of America.

J Laryngol Otol 2020 Nov 3:1-6. Epub 2020 Nov 3.

Mersey ENT Trainee Research Collaborative, Liverpool University Hospitals NHS Foundation Trust, UK.

Background: There are sparse data on the outcomes of endoscopic stapling of pharyngeal pouches. The Mersey ENT Trainee Collaborative compared regional practice against published benchmarks.

Methods: A 10-year retrospective analysis of endoscopic pharyngeal pouch surgery was conducted and practice was assessed against eight standards. Read More

BMJ Case Rep 2020 Oct 31;13(10). Epub 2020 Oct 31.

Oral and Maxillofacial Surgery, Krishna Institute of Medical Sciences Deemed University, Karad, India

Oral mucosa exhibit clinical manifestations of a variety of systemic conditions and can serve as an indicator of overall health of an individual. Various systemic conditions like autoimmune, endocrine and haematological disorders can present with oral mucosal lesions, which can serve as an important diagnostic feature. These oral lesions can vary from oral ulceration, bleeding gums, xerostomia, chronic glossitis, to erosion and sensitivity of teeth. Read More

Am J Otolaryngol 2021 Jan - Feb;42(1):102769. Epub 2020 Oct 22.

Johns Hopkins University School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Division of Laryngology, 601 N Caroline Street, Baltimore, MD 21231, United States of America. Electronic address:

Surg Clin North Am 2020 Dec 10;100(6):1215-1226. Epub 2020 Oct 10.

Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL 60201, USA.

Zenker diverticulum (ZD) is a rare but treatable surgical disease affecting the elderly. This article reviews current available evidence and management of ZD, which includes open surgical, rigid endoscopic, and flexible endoscopic diverticulotomy with common goal of complete division of cricopharyngeus muscle. Careful patient selection and operative intervention tailored to patient characteristics is important when evaluating patients for operative intervention for ZD. Read More

Am J Otolaryngol 2021 Jan - Feb;42(1):102755. Epub 2020 Oct 17.

UCI Health Voice and Swallowing Center, Department of Otolaryngology Head and Neck Surgery, University of California Irvine School of Medicine, CA, United States of America. Electronic address:

Objective: This study identifies how recurrent Zenker's diverticula are treated.

Methods: A retrospective chart review was performed from four tertiary referral academic voice and swallowing centers to identify individuals who underwent surgery for recurrent Zenker's diverticulum. Demographic data, surgical modalities for primary and revision surgery, symptoms pre and post revision and complications were recorded. Read More

Thorac Cardiovasc Surg 2021 04 21;69(3):228-230. Epub 2020 Oct 21.

Center for Esophageal Diseases, Baylor University Medical Center at Dallas, Dallas, Texas, United States.

Objective: With the advent of minimally invasive surgery, incisionless surgery, and third-space endoscopy, the treatment for Zenker's diverticulum has also moved toward less invasive techniques METHODS:  New incisionless per oral techniques can be applied for cricopharyngeal myotomy in Zenker's diverticulum.

Results: Five patients underwent Zenker's diverticulum per oral endoscopic myotomy (Z-POEM) without complications, minimal discomfort, and narcotic consumption, with complete resolution of their symptoms by history and Eckardt scores.

Conclusions: Z-POEM is performed entirely endoscopically with very little associated pain or complication rates, with short-term follow-up having excellent functional and symptomatic results. Read More

Surg Laparosc Endosc Percutan Tech 2020 Oct;30(5):e30-e32

Digestive and Interventional Endoscopy Unit.

Endoscopic diverticulotomy associated with cricopharyngeal myotomy is a well-known and safe treatment for Zenker diverticulum. We describe our first 5 consecutive cases treated by a new variant of the technique that allows a deeper and longer myotomy than the standard one. Technical success was achieved in all the cases. Read More

Ann Otol Rhinol Laryngol 2021 May 1;130(5):497-503. Epub 2020 Oct 1.

Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, CA, USA.

Objective: To describe rates of short-term morbidity following transcervical surgical treatment of hypopharyngeal diverticulum (HD) and analyze predictors of adverse events.

Methods: The 2005 to 2017 National Surgical Quality Improvement Program database was queried to identify patients diagnosed with HD undergoing open transcervical diverticulectomy.

Results: A total of 597 patients with a mean age of 71. Read More

Ear Nose Throat J 2020 Sep 24:145561320959569. Epub 2020 Sep 24.

Department of ENT, 129367Charing Cross Hospital, Imperial College Healthcare, London, United Kingdom.

Cricopharyngeal spasm and pharyngeal pouch can result in severe dysphagia symptoms that can have a significant impact on a patient's quality of life. Several surgical interventions have been demonstrated including balloon dilatation, botox injection, and open and endoscopic cricopharyngeal myotomy. The aim of this case series is to describe our technique for endoscopic cricopharyngeal myotomy and compare pre- and postoperative swallowing outcomes using objective swallowing questionnaires in a small series of patients. Read More

Eur Arch Otorhinolaryngol 2021 Jul 7;278(7):2625-2630. Epub 2020 Sep 7.

Division of General and Foregut Surgery, IRCCS Policlinico San Donato, University of Milan, Piazza Malan 1, 20097, San Donato Milanese, Milan, Italy.

Purpose: Despite the evolution of the endoscopic techniques for the treatment of symptomatic Zenker diverticulum, comparative studies are lacking. Aim of this observational study was to compare safety, efficacy, and outcomes of endoscopic stapling (ES) versus Laser (EL).

Methods: A prospectively collected database of patients who underwent treatment for Zenker diverticulum at a single institution was reviewed. Read More

Ann Thorac Surg 2021 04 3;111(4):e257-e258. Epub 2020 Sep 3.

University of Missouri School of Medicine, Columbia, Missouri; Division of Cardiothoracic Surgery, Department of Surgery, University of Missouri Health, Columbia, Missouri.

A fistula between a Zenker's diverticulum and the trachea has only been reported once, in 1983. Here, we report a case of a fistula between a large Zenker's diverticulum and the trachea with complete occlusion of the esophagus. The fistula was repaired, first by an esophageal myotomy, followed by proximal resection of the diverticulum, completion of the esophageal myotomy, transection of the fistula, and repair of the trachea. Read More

Laryngoscope Investig Otolaryngol 2020 Aug 4;5(4):708-717. Epub 2020 Aug 4.

Department of Surgery, Division of Otolaryngology-Head and Neck Surgery University of Wisconsin-Madison Madison Wisconsin USA.

Objectives: Zenker's diverticulum is associated with reduced cricopharyngeal compliance and abnormal intrabolus pressure. However, it is unclear how the pharynx compensates for these deficits. Developments in manometric technology have improved our ability to capture pharyngeal pressure events. Read More

Surg Endosc 2021 Jul 11;35(7):3744-3752. Epub 2020 Aug 11.

Gastroenterology and Endoscopy Unit, Hospices Civils de Lyon, Hôpital E.Herriot, Lyon, France.

Introduction: Different treatments exist for Zenker diverticulum. We compared flexible endoscopic myotomy of the cricopharyngeal muscle, using a technique called the "window technique" in order to improve the field of view, to surgical approaches.

Materials And Methods: Patients were retrospectively included and divided into a gastrointestinal group, with flexible endoscopic myotomy, and an ear-nose-throat treatments group with either rigid endoscopic treatment, either cervicotomy. Read More

Endoscopy 2021 Apr 5;53(4):E148-E149. Epub 2020 Aug 5.

Department of Gastroenterology, Chongqing University Cancer Hospital, Chongqing, China.