title: Clinical relevance and prognostic value of radiographic findings in Zenker's diverticulum.
abstract: The aim of this study was to evaluate the clinical relevance and prognostic value of preoperative and postoperative oesophagography in patients with Zenker's diverticulum. The medical records of 155 patients who underwent surgical treatment (with an endoscopic or transcervical approach) for Zenker's diverticulum between 1992 and 2010 in a tertiary referral centre were retrospectively evaluated. The size of the diverticula on oesophagography, recognizable muscular septum, and protection of the diverticulum were assessed relative to the surgical procedures performed. The incidence of diverticular remnants on postoperative oesophagography was also assessed relative to the surgical procedure. It was investigated whether the detection of a residual pharyngeal pouch and filling of it with contrast medium were related to the patients' immediate postoperative symptoms and the development of symptomatic recurrence. Larger diverticula (Brombart III-IV) were manageable significantly more often with endoscopic procedures (P = 0.007). Residual diverticulum and filling with contrast medium were strongly associated with prolonged dysphagia immediately postoperatively (P = 0.005 and P = 0.009, respectively). However, these parameters failed to correlate significantly with a symptomatic recurrence. Preoperative oesophagography proved to be extremely important for surgical planning, with the surgeon's personal preference seeming to be the driving indicator in many cases. Postoperative oesophagography is only useful for excluding postoperative complications in the immediate postoperative phase and did not have a prognostic value as to a recurrence of the disease.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg Medical School, Waldstrasse 1, 91054, Erlangen, Germany, konstantinos.mantsopoulos@uk-erlangen.de.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Mantsopoulos
authors.forename: Georgios
authors.initials: G
authors.lastname: Psychogios
authors.forename: Alexander
authors.initials: A
authors.lastname: Karatzanis
authors.forename: Julian
authors.initials: J
authors.lastname: Künzel
authors.forename: Michael
authors.initials: M
authors.lastname: Lell
authors.forename: Johannes
authors.initials: J
authors.lastname: Zenk
authors.forename: Michael
authors.initials: M
authors.lastname: Koch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D015331:Cohort Studies; D003287:Contrast Media; D003680:Deglutition Disorders / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D004945:Esophagoscopy; D004947:Esophagus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate