title: Short-term Quality-of-Life Outcomes following Transoral Diverticulotomy for Zenker's Diverticulum: A Prospective Single-Group Study.
abstract: OBJECTIVE
  To prospectively analyze quality-of-life outcomes following transoral diverticulotomy with cricopharyngeal myotomy (DCPM) for Zenker's diverticulum (ZD).
  
  
  METHODS
  Prospective single-group study.
  
  
  METHODS
  Tertiary academic institution.
  
  
  METHODS
  A prospective multicenter study performed from January 1, 2012, to July 1, 2014, included 18 patients presenting with ZD undergoing DCPM. Standardized questionnaires-including the 10-item Eating Assessment Tool (EAT-10), Functional Outcome of Swallowing Scale (FOSS), and the Reflux Symptom Index (RSI)-were completed preoperatively and at 3 and 6 months postoperatively. Videofluoroscopic studies were obtained and analyzed by our senior speech-language pathologist, who was blinded to the clinical outcomes.
  
  
  RESULTS
  Eighteen patients were included (11 women; mean age, 72.6 years; range, 53-86 years). All patients had ZD on preoperative videofluoroscopic swallowing studies. The most common comorbidities included hypertension (10 of 18, 55.6%), dyslipidemia (8 of 18, 44.4%), hiatal hernia (6 of 18, 33.3%), and gastroesophageal reflux disease (5 of 18, 27.8%). Median preoperative RSI was 27 (interquartile range [IQR], 22.5-31.5); FOSS, 2 (IQR, 2-3); and EAT-10, 21.5 (IQR, 13.5-27.5). The 3-month questionnaire (88.9% completion) demonstrated an improved median RSI of 5 (IQR, 1-7.5; P < .001), FOSS of 0 (IQR, 0; P < .001), and EAT-10 of 0 (IQR, 0-3; P < .001). Fourteen patients (77.8%) completed the 6-month questionnaire, demonstrating a median RSI of 4 (IQR, 0-8), FOSS of 0 (IQR, 0-0.5), and EAT-10 of 1 (IQR, 0-3). While regurgitation decreased following surgery (P = .007), nighttime cough did not (P = .25).
  
  
  CONCLUSIONS
  This study supports an improvement in functional outcome and quality of life in patients with ZD undergoing DCPM.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA vanabel.kathryn@mayo.edu.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Van Abel
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Tombers
authors.affiliation: Department of Speech and Language Pathology, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
authors.forename: Kari A
authors.initials: KA
authors.lastname: Krein
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Moore
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Price
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
authors.forename: Jan L
authors.initials: JL
authors.lastname: Kasperbauer
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Hinni
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Lott
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
authors.forename: Dale C
authors.initials: DC
authors.lastname: Ekbom
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016672:Zenker Diverticulum / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*
keywords: EAT-10; FOSS; RSI; Zenker’s diverticulum; cricopharyngeal bar; cricopharyngeal dysfunction; cricopharyngeal myotomy; functional outcome swallowing scale; quality of life; reflux symptom index; regurgitation