Kocatürk Sinan, Beriat Güçlü Kaan, Doğan Cem
Department of Otolaryngology, Medicine Faculty of Ufuk University, Ankara, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2009 Nov-Dec;19(6):311-5.
Zenker's diverticulum is a pulsion typed pharyngoeosophageal diverticle caused by the herniation of the pharyngeal mucosa, standing beside the posterior pharyngeal wall, through the Killian opening which is known as the weak area between the inferior constructor muscle's oblique fibres and transverse fibres of cricopharyngeal muscle. In patients with Zenker's diverticulum, symptoms such as disfagia, globus in the cervical area, weigh loss, regurgitation, cough, and aspiration. These patients are primarily admitted to the Gastroenterology and Othorhinolaryngology clinics with the complaint of disfagia and the diagnosis of this disease is mostly established late and the treatment is started late because the results of their physical examinations seem normal. Therefore, especially in the patients who have disfagia complaint, pharyngoeosophageal diverticle prediagnosis should be thought and that should be examined by passage graphies with barium and endoscopic methods, if needed. In this article, we presented the 67-year-old Zenker's diverticulum patient in whom we performed open diverticulectomy and posterior cricopharyngeal myotomy, and we specified the important points in choosing the patient and the type of surgery.
Zenker憩室是一种因咽黏膜经Killian孔疝出而形成的压力性咽食管憩室,该孔位于咽后壁旁,是咽下缩肌斜行纤维与环咽肌横行纤维之间的薄弱区域。Zenker憩室患者会出现吞咽困难、颈部异物感、体重减轻、反流、咳嗽及误吸等症状。这些患者主要因吞咽困难症状就诊于胃肠病科和耳鼻咽喉科门诊,由于体格检查结果看似正常,该病的诊断大多较晚,治疗也开始得较晚。因此,尤其是对于有吞咽困难主诉的患者,应考虑咽食管憩室的初步诊断,如有必要,应通过钡剂造影和内镜检查进行评估。在本文中,我们介绍了一位67岁接受开放性憩室切除术和环咽肌后肌切开术的Zenker憩室患者,并阐述了选择患者及手术方式的要点。