A Zenker’s diverticulum, more formally known as a hypopharyngeal diverticulum, is a pouch that can form at the junction of the hypopharynx (lower part of the throat) and the esophagus, an area known as Killian’s Triangle. This pouch typically causes problems by trapping food as it is being swallowed, leading to choking and aspiration.
What causes a Zenker’s Diverticulum?
A Zenker’s diverticulum typically arises due to tightness of the cricopharyngeus muscle. This muscle makes up the upper esophageal sphincter, and is located just below the level of the voice box. Normally, it relaxes during swallowing to allow food to pass into the esophagus. When this muscle fails to relax, the pressure of swallowing pushes the food against the posterior wall of the hypopharynx, causing it to bulge slightly. The combination of obstruction, pressure and bulging, repeated over thousands of swallows, eventually leads to a permanent bulge or pouch — a Zenker’s diverticulum. The diverticulum continues to enlarge as more and more food is pressed into it.
What are the symptoms of Zenker’s Diverticulum?
The classic symptoms of a Zenker’s diverticulum consist of difficulty swallowing, a feeling a lump or fullness in the throat, and subsequent regurgitation of undigested trapped food minutes to hours after eating. This unexpected regurgitation of food can lead to aspiration (food particles entering the windpipe and lungs) and, in some cases, pneumonia.
How is a Zenker’s Diverticulum treated?
If a Zenker’s diverticulum is causing symptoms, surgical treatment may be needed, but often we are able to correct most of these outpouchings with a minimally invasive approach through the mouth, avoiding external neck incisions.
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