Therapy of Zenker's diverticulum.

INTRODUCTION

Zenker's diverticulum is a rare disease, which can cause considerable suffering. The classic presentation is worsening dysphagia. Anatomically there is a loose bulge of the dorsal wall of the hypopharynx. A septum between the diverticulum and the lumen of the esophagus can develop and hamper the passage of food. Therapeutic options include the open diverticular resection in combination with myotomy of the cricopharyngeus muscle, or endoluminal or transoral approaches which merely split the septum by means of rigid or flexible endoscopy.

METHODS

Selective review of literature found in Medline.

RESULTS

Significant relief is achievable in more than 90% of cases by one or another approach. Endoluminal methods have lower complication rates but higher recurrence rates.

DISCUSSION

Treatment planning should be interdisciplinary, and take into account individual anatomy and risk factors, as well as local expertise.