Clinical findings and treatments of patients with Zenker's diverticulum

Pharyngoesophageal diverticulum (Zenker's diverticulum), which is a pulsion diverticulum that occurs at a weak site in the posterior wall of the pharyngoesophagus, between the inferior constrictor of pharynx and the cricopharyngeus muscle, i.e. Killian's triangle, is rare in Japan. We treated 7 patients with Zenker's diverticulum surgically from 1988 to 2003. We reviewed clinical findings and treatments of them. All had dysphagia initially. All underwent diverticulectomy, and 4 additionally underwent cricopharyngeal myotomy (CM). Postoperatively, 6 patients experienced dramatic alleviation of symptoms. Postoperative complications occurred in 2, i.e. pneumonia in 1 and recurrent laryngeal nerve paralysis in the other. No postoperative recurrence was seen. We suggest that diverticulectomy added to CM is effective for Zenker's diverticulum. The patients with a large diverticulum are at risk of postoperative surgical complications due to the difficulty of the surgery, so careful operation is needed for them.