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Zenker's Diverticulum

Zenker's diverticulum is a pouch, or diverticulum, that occurs in the throat near the base of the neck. Over time, the pouch enlarges in size as the muscles below it tighten excessively; this causes swallowing to become increasingly difficult. Often experienced by older and elderly patients, this condition is quite bothersome but highly treatable following a proper diagnosis.

Zenker's Diverticulum Symptoms

There are a number of symptoms that can point to the presence of Zenker's diverticulum. In order to make a diagnosis of this condition, it is necessary to conduct an X-ray swallowing study or an endoscopy to fully view the affected area. Symptoms of this condition include:

  • Difficult and uncomfortable swallowing
  • Regurgitation of food many hours following a meal
  • Choking or coughing when attempting to consume solid foods
  • A feeling of excessive phlegm or mucus in the throat
  • Persistent sensation of "a lump in the throat"

Effects of Zenker's Diverticulum

Untreated Zenker's diverticulum can have a significant negative impact on a patient's quality of life, especially concerning the consumption of food. It is not only unpleasant, however; this condition can also be dangerous and escalate the risk of choking on food while eating. In addition, Zenker's diverticulum also puts a patient at risk of food entering the lungs which is called aspiration, causing serious illness, pneumonia, or even death. This means that treatment is important for Zenker's diverticulum, even for pouches that are small in size.

Cause of Zenker’s Divertiuclum

The cricopharyngeus is a muscle that circles around the base of the throat. In some individuals this muscle “over-tightens,” causing the throat above it to pouch out. That pouch is the Zenker’s diverticulum.

Treatment for Zenker's Diverticulum

Treatment for Zenker’s diverticulum is surgery. The surgery consists of cutting the cricopharyngeus muscle, the cause of the problem. Once the muscle has been cut, it is easy for food to properly enter the esophagus without an obstruction; food and other items will no longer stuck in the diverticulum, and it will no longer be difficult to swallow. In addition, patients will not feel the presence of the diverticulum at the back of their throats.

Surgical Options for Zenker's Diverticulum Treatment

The preferred surgical approach for smaller Zenker's diverticulum pouches is to perform this procedure with a minimally invasive approach through the mouth. In patients with smaller pouches, the surgeon can use a laser or a surgical stapler to cut the cricopharyngeus muscle. This procedure takes only fifteen minutes in most cases to fully perform.

For patients with larger pouches, a cut is made on the neck and the muscle is cut through what is known as an external approach. At the same time the pouch is cut out and the throat is sewn This does take longer to complete as it is more complex; however, it also has an excellent record of successful recovery and patient health. This "open" surgical procedure is very safe and effective and has been performed successfully on many patients, including elderly patients over 90 years old who have experienced full recovery.