Presented at the American Academy of Otolaryngology—Head and Neck Surgery Annual Meeting, San Francisco, CA, September 11–14, 2011.
Head and Neck
Patient reported outcomes in endoscopic and open transcervical treatment for Zenker's diverticulum
Article first published online: 22 OCT 2013
© 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 124, Issue 1, pages 119–125, January 2014
How to Cite
Seth, R., Rajasekaran, K., Lee, W. T., Lorenz, R. R., Wood, B. G., Kominsky, A. and Scharpf, J. (2014), Patient reported outcomes in endoscopic and open transcervical treatment for Zenker's diverticulum. The Laryngoscope, 124: 119–125. doi: 10.1002/lary.24152
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 20 DEC 2013
- Article first published online: 22 OCT 2013
- Manuscript Accepted: 22 MAR 2013
- Zenker diverticulum;
- esophageal diverticulum;
- endoscopic diverticulotomy;
- transcervical diverticulectomy;
- cricopharyngeal bar;
- cricopharyngeal myotomy;
- endoscopic stapling diverticulotomy
To compare long-term symptomatic outcomes between external transcervical (ET) and endoscopic stapling diverticulotomy (ESD) surgeries for Zenker's diverticulum.
Patients undergoing surgery for Zenker's diverticulum surgery between 1998 and 2010 with at least 1 year follow-up were telephoned and questioned for dysphagia, choking, regurgitation, and halitosis based on a validated Gastrointestinal Quality-of-Life Index. Symptom degree preoperatively and at phone call was assessed. Patients rated their overall postoperative symptoms as worsened, unchanged, improved, or completely resolved.
A total of 96 patients were eligible for inclusion and 55 were successfully contacted. Of these, 24 underwent ESD and 31 had ET operations. Average follow-up time was significantly longer for the ET group than the ESD group (5.7 vs. 3.1 years respectively, P < 0.01). Gender, age at operation, diverticulum size, and preoperative symptom scores were not statistically different between the two groups. For both techniques, symptom scores showed significant improvement postoperatively (P < 0.01). A greater proportion of patients undergoing ET procedures reported their symptoms to be completely resolved or improved compared with the ESD group (93% vs. 67%, P = 0.015). Patients undergoing ET demonstrated a greater change or improvement in survey score compared to ESD patients (7.23 vs. 3.42, P = 0.014).
Both the ET and ESD surgeries significantly benefit patients, regardless of diverticulum size. Long-term symptomatic outcomes between the two populations indicate that patients with ET procedures attain a greater degree of resolution of preoperative symptoms.
Level of Evidence
4. Laryngoscope, 124:119–125, 2014