Pharyngeal adaptation in Zenker's diverticulum: the "faux pharyngoesophageal segment".
BACKGROUND
We have noticed a protrusion on the pharyngeal wall in patients with Zenker's diverticulum (ZD). The protrusion gives the appearance of a neo-pharyngoesophageal segment (faux-PES) and may represent an adaptation to protect the airway.


METHODS
A case-control study.


METHODS
The fluoroscopic swallow studies of patients with ZD were compared with matched controls. Information regarding the presence and location of a faux-PES, true PES opening, pharyngeal constriction, and laryngohyoid elevation was compared.


RESULTS
The fluoroscopic swallow studies of 31 patients with ZD were compared with 31 controls. A faux-PES was found in 100 percent of ZD patients and in 0 percent of controls. The mean maximum opening of the faux-PES was 1.5 (+/-0.27) cm. The faux-PES was located 1 cm above the true PES below the entrance to the supraglottic airway. This is the optimal location for airway defense.


CONCLUSIONS
The faux-PES was identified in 100 percent of patients with ZD. The faux-PES may represent a physiologic adaptation to protect the airway from regurgitation out of a ZD.
Leonard
Rebecca
R
The Center for Voice and Swallowing of The University of California, Davis, Sacramento, CA.
Belafsky
Peter
P
McKenzie
Susan
S
D000222:Adaptation, Physiological; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000503:physiopathology*; D016672:Zenker Diverticulum / Q000503:physiopathology*