title: Dysphagia characteristics in Zenker's diverticulum.
abstract: OBJECTIVE
  To evaluate dysphagia characteristics in patients with Zenker's diverticulum (ZD).
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Outpatient tertiary care dysphagia clinic.
  
  
  METHODS
  All ZD cases surgically treated over a 6-year period were identified and reviewed for dysphagia history and dysphagia characteristics on initial presentation using fiber-optic endoscopic evaluation of swallowing (FEES). Dysphagia symptoms and swallowing abnormalities were compared across groups based on diverticulum size (small <1 cm, medium 1-3 cm, and large >3 cm).
  
  
  RESULTS
  Forty-six patients underwent a total of 52 procedures during the study period. ZD size was available in 49 cases (6 small, 26 medium, 17 large). Regurgitation symptoms were less frequent in patients with small (17%) compared with medium (68%) or large diverticula (76%; P = .03). Postswallow hypopharyngeal reflux (PSHR) was less frequent in patients with small (17%) compared with medium (91%) and large diverticula (87%; P < .01). PSHR was present on all FEES available for patients who presented with a recurrent or residual ZD (n = 7). In all cases, PSHR resolved after successful treatment of ZD. Pharyngeal residue indicating possible weakness was present in 24% of all patients at initial presentation.
  
  
  CONCLUSIONS
  Preoperative assessment of dysphagia characteristics in ZD patients reveals that PSHR is predictive of a ZD larger than 1 cm and may be useful in surgical planning. PSHR is also helpful in identifying patients with recurrent or residual symptomatic ZD following surgical treatment. Pharyngeal weakness is present in a subset of ZD patients.
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California 90095, USA. jbergeron@mednet.ucla.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Bergeron
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Long
authors.forename: Dinesh K
authors.initials: DK
authors.lastname: Chhetri
mesh_terms: D003680:Deglutition Disorders / Q000503:physiopathology* / Q000601:surgery; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016672:Zenker Diverticulum / Q000503:physiopathology* / Q000601:surgery