title: Role of the "rising tide sign" in the diagnosis and assessment of the results of surgery for Zenker's diverticulum.
abstract: OBJECTIVE
  To evaluate the role of the videoendoscopic "rising tide sign" (RTS) in the diagnosis and assessment of surgical repair of Zenker's diverticulum.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  A total of 148 patients with Zenker's diverticulum underwent surgery in our department. A videoendoscopic swallowing study (VESS) was performed pre- and postoperatively, and the two examinations compared for the presence of the RTS. VESS characteristics based on the time to RTS onset and the size of diverticulum, as seen on a barium swallow, were also compared in a subset of 38 patients.
  
  
  RESULTS
  All patients presented with the RTS on preoperative VESS. No correlation was observed between the time to onset of the sign and size of the diverticulum. Follow-up data were available for 121 patients (mean follow-up: 8 months): 111 patients were significantly improved during follow-up, with complete disappearance of the RTS. Recurrence of symptoms was observed at this time in 10 patients. Seven of these 10 patients had concomitant recurrence of the RTS and required repeat surgery after a mean follow-up of 37 months.
  
  
  CONCLUSIONS
  The RTS observed by videoendoscopy is a supplementary tool for the diagnosis of Zenker's diverticulum and for evaluation of the efficacy of surgery during the postoperative follow-up.
authors.affiliation: Service d'ORL et Chirurgie Cervico-Faciale, Université Pierre et Marie-Curie, Paris 6, Hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Department of Otolaryngology-HNS, RenJi Hospital of Shanghai Jiao-Tong University, 200001 Shanghai, China.
authors.forename: J-R
authors.initials: JR
authors.lastname: Chen
authors.forename: H
authors.initials: H
authors.lastname: Mirghani
authors.forename: A
authors.initials: A
authors.lastname: Jafari
authors.forename: O
authors.initials: O
authors.lastname: de Crouy Chanel
authors.forename: S
authors.initials: S
authors.lastname: Périé
authors.forename: J
authors.initials: J
authors.lastname: Lacau St Guily
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003287:Contrast Media; D003679:Deglutition; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D057234:Preoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D014741:Video Recording; D016672:Zenker Diverticulum / Q000175:diagnosis* / Q000601:surgery
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate
keywords: Swallowing; Videoendoscopy swallowing study; Zenker's diverticulum; “Rising tide sign”