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Zenker's Diverticulum

Zenker's diverticulum is a pouch that forms in the throat, where the esophagus meets a part of the throat called the pharynx. The pouch forms by pushing through a weakened portion of the pharynx and balloons outward. The condition tends to occur in patients over 60 years but may occur in younger patients. It does not appear to be hereditary.

The main symptom of Zenker's diverticulum is dysphagia, or difficulty swallowing. Undigested food or liquid can rise back into the throat and mouth even hours after swallowing. Other symptoms include choking, a buildup of mucous in the throat, bad breath, hoarseness, and recurrent pneumonias.

If you suspect you have Zenker's diverticulum, or any form of swallowing disorder, Temple's highly experienced otolaryngologists can diagnose and treat your condition.

Zenker's Diverticulum Patient Story: Melinda

How is Zenker's diverticulum treated?

In cases of mild dysphagia, Zenker's diverticulum can be treated with lifestyle changes. These include:
  • Avoiding fatty, spicy and acidic foods
  • Thoroughly chewing foods before swallowing
  • Drinking lots of water after eating
If dysphagia is severe, Temple's board-certified head and neck surgeons are highly experienced in a range of surgical treatments. All of the procedures aim to repair the weakened portion of the pharynx and provide relief from the obstruction. The exact procedure our surgeons use will depends on the size and location of the diverticulum.

Surgical options include:
  • Cricopharyngeal myotomy: This procedure is ideal for removing small diverticula. It can be performed through an open incision, or directly through the mouth.
  • Diverticulopexy with cricopharyngeal myotomy: This procedure is used for larger diverticula. Instead of removing diverticulum, a Temple head and neck surgeon flips the pouch upside down and attaches it to the wall of the esophagus with sutures.
  • Diverticulectomy and cricopharyngeal myotomy: The oldest surgical treatment for Zenker's diverticulum, this procedure is the complete removal of the pouch along with a cricopharyngeal myotomy. Temple’s head and neck surgeons perform this through a small neck incision for the small percentage of patients where the sac is very large or cannot be accessed through the mouth.
  • Endoscopic diverticulotomy: this option involves surgically dividing the wall between the esophagus and the diverticulum. Once the wall is divided, food particles stuck inside the pouch are free to drain into the esophagus. To perform endoscopic diverticulotomy, Temple’s head and neck surgeons use a special tool called a diverticuloscope, as well special surgical staples, to ensure an entirely minimally invasive procedure. The vast majority of Zenker’s diverticula are treated successfully in this minimally invasive manner.