Zenker’s diverticulum is a condition that is most often seen in older adults. It occurs when a pouch, also called a diverticulum, develops in the throat at the base of the neck. As the pouch increases in size, swallowing becomes difficult.
Symptoms of Zenker’s Diverticulum
- Swallowing that is difficult
- Frequent coughing or choking while eating solid foods
- Regurgitation of food several hours after a meal
- The sensation of having excessive mucus or phlegm in the throat
The diagnosis of Zenker’s diverticulum is normally confirmed following a visual inspection of the affected area using an endoscope or a swallowing study known as a modified barium swallow study or esophagram.
Causes of Zenker’s Diverticulum
The bottom of the throat is surrounded by a muscle called the cricopharyngeus. In patients with Zenker’s diverticulum, this muscle becomes overly tight, which causes the portion of the throat above the muscle to pouch out.
Effects of a Zenker’s Diverticulum
If left untreated, a Zenker’s diverticulum will make swallowing worse and negatively affect one’s quality of life. Not only does the condition make eating unpleasant, but it also increases the individual’s risk of choking. Patients with a Zenker’s diverticulum are also at increased risk for aspirating or inhaling food or saliva into the lungs. This can lead to serious illnesses, such as pneumonia, or even death. Individuals with the condition are urged to seek treatment even if the pouches are still small.
Treating Zenker’s Diverticulum
A Zenker’s diverticulum can be corrected through surgery. This involves cutting the cricopharyngeus muscle which causes constriction. This procedure allows the food to pass through to the esophagus easily. The surgery eliminates the swallowing difficulties and reduces the risk of food getting stuck in the diverticulum. The patient also no longer feels the pouch at the back of the throat, so they no longer have the sensation of a persistent lump in their throat.
Surgical Treatment Options
If the diverticulum is small, the preferred surgical technique is a minimally invasive approach in which the pouch is accessed through the mouth. The surgeon then uses a surgical stapler or laser to cut the cricopharyngeus muscle. This surgical option typically takes about 15 to 30 minutes to complete.
Patients with a large diverticulum may require an external approach. This involves making a cut through the neck in order to remove the pouch and cut the cricopharyngeus muscle. This procedure is more complex and takes longer to perform; however, it is very safe and has a long record of successful patient outcomes. Even patients well into their 90s have undergone the procedure successfully and experienced a full recovery.