Pharyngeal (Zenker's) diverticulum is a disorder of upper esophageal sphincter opening

1992 ◽  
Vol 103 (4) ◽  
pp. 1229-1235 ◽  
Author(s):  
Ian J. Cook ◽  
Mary Gabb ◽  
Voula Panagopoulos ◽  
Glyn G. Jamieson ◽  
Wylie J. Dodds ◽  
...  
Dysphagia ◽  
1988 ◽  
Vol 3 (2) ◽  
pp. 90-92 ◽  
Author(s):  
T. Frieling ◽  
W. Berges ◽  
H. J. Lübke ◽  
P. Enck ◽  
M. Wienbeck

2002 ◽  
Vol 283 (1) ◽  
pp. G16-G26 ◽  
Author(s):  
Rohan B. H. Williams ◽  
Karen L. Wallace ◽  
Galib N. Ali ◽  
Ian J. Cook

Our aims were to examine the etiology and biomechanical properties of the nonrelaxing upper esophageal sphincter (UES) and the relationship between UES opening and failed relaxation. We examined the relationships among swallowed bolus volume, intrabolus pressure, sagittal UES diameter, the pharyngeal swallow response, and geniohyoid shortening in 18 patients with failed UES relaxation, 23 healthy aged controls, and 15 with Zenker's diverticulum. Etiology of failed UES relaxation was 56% medullary disease, 33% Parkinson's or extrapyramidal disease; and 11% idiopathic. Extent of UES opening ranged from absent to normal and correlated with preservation of the pharyngeal swallow response ( P = 0.012) and geniohyoid shortening ( P = 0.046). Intrabolus pressure was significantly greater compared with aged controls ( P < 0.001) or Zenker's diverticulum ( P < 0.001). The bolus volume-dependent increase in intrabolus pressure evident in controls was not observed in failed UES relaxation. The nonrelaxing UES therefore displays a constant loss of sphincter compliance throughout the full, and potentially normal, range of expansion during opening. Adequacy of UES opening is influenced by the degree of preservation of the pharyngeal swallow response and hyolaryngeal traction. In contrast, the stenotic UES displays a static loss of compliance, only apparent once the limit of sphincter expansion is reached.


1997 ◽  
Vol 70 (1) ◽  
pp. 46-48 ◽  
Author(s):  
Marco Venturi ◽  
Luigi Bonavina ◽  
Laura Colombo ◽  
Laura Antoniazzi ◽  
Alessandra Bruno ◽  
...  

2016 ◽  
Author(s):  
Hiroshi Mashimo

A wide variety of disorders can affect the pharynx and upper esophagus, such as inherited or acquired structural abnormalities, malignancies, and inflammation secondary to a number of etiologies including bacterial, yeast and viral infections, irradiation, and gastroesophageal reflux disorder. Laryngoceles and peritonsillar abscess can also lead to pain and dysfunction. However, this review will focus on the main motility disorders that affect the pharynx and upper esophagus, namely oropharyngeal dysphagia, disorders associated with globus pharyngeus, and Zenker’s diverticulum. Figures show the anatomy of the three stages of normal swallow, various findings on functional endoscopic evaluation of swallowing, electromyography of the cricopharyngeal sphincter and submental muscles, and Zenker’s diverticulum. Tables list causes of oropharyngeal dysphagia, neuromuscular control of the pharyngeal phase (with identified cranial and cervical spinal nerve roots), pathophysiology of oropharyngeal dysplasia, diagnostic tests for oropharyngeal dysplasia, behavioral treatments to improve swallow and reduce aspiration, and potential overlapping causes of impaired upper esophageal sphincter relaxation.   This review contains 4 highly rendered figures, 6 tables, and 40 references   Key words: Oropharyngeal dysphagia; Globus; Upper esophageal sphincter dysfunction; Swallowing disorder; Dysphagia; Zenker’s diverticulum; Swallow assessment; Globus pharyngeus


2017 ◽  
Vol 68 (3) ◽  
pp. 240-244
Author(s):  
Sumiyo Saburi ◽  
Yoichiro Sugiyama ◽  
Hideki Bando ◽  
Ryuichi Hirota ◽  
Yasuo Hisa ◽  
...  

Author(s):  
Eitan Podgaetz ◽  
Vani Konda

Abstract Objective With the advent of minimally invasive surgery, incisionless surgery, and third-space endoscopy, the treatment for Zenker's diverticulum has also moved toward less invasive techniques Methods New incisionless per oral techniques can be applied for cricopharyngeal myotomy in Zenker's diverticulum. Results Five patients underwent Zenker's diverticulum per oral endoscopic myotomy (Z-POEM) without complications, minimal discomfort, and narcotic consumption, with complete resolution of their symptoms by history and Eckardt scores. Conclusions Z-POEM is performed entirely endoscopically with very little associated pain or complication rates, with short-term follow-up having excellent functional and symptomatic results.


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