Venkatesan Naren N, Evangelista Lisa M, Kuhn Maggie A, Belafsky Peter C
Department of General Surgery, University of North Texas-Health Sciences Center, Fort Worth, Texas, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, University of California-Davis, Sacramento, California, U.S.A.
Laryngoscope. 2017 Aug;127(8):1762-1766. doi: 10.1002/lary.26446. Epub 2017 Jan 4.
Endoscopic Zenker diverticulotomy (EZD) is a primary treatment for Zenker diverticulum (ZD). During EZD, the diverticulum is not excised, and interpretation of postoperative videofluoroscopic swallow study (VFSS) is challenging. The purpose of this investigation was to describe normal VFSS findings status post-successful EZD.
The charts of all patients with ZD treated at our center between October 01, 2011, and May 30, 2014, were abstracted. Outcome measures included recidivistic diverticulum size, Eating Assessment Tool-10 (EAT-10), penetration aspiration scale, pharyngeal constriction ratio (PCR), and pharyngoesophageal segment (PES) opening.
Twenty patients met inclusion criteria. The mean age was 70.5 (± 13) years. Seventy percent of the patients were male. Mean EAT-10 decreased 72.1% from 17.9 (± 8.2) to 5 (± 6.9) (P < 0.0001), and diverticulum size decreased 50.9% from 1.96 cm (± 0.68) to 0.96 cm (± 0.57) (P < 0.001). The PCR improved 33.6% from 0.17 (± 0.13) to 0.11 (± 0.11) (P < 0.001). Mean PES opening increased 61.6% from 0.53 cm (± 0.3544) to 0.86 cm (± 0.29) in lateral view and increased 40.0% from 1.00 cm (± 0.54) to 1.39 cm (± 0.46) in anteroposterior view (P < 0.001).
VFSS following successful EZD demonstrates an approximate 50% reduction in diverticulum size and significant improvement in PCR and PES opening. These data provide a framework for the expected fluoroscopic outcomes of successful diverticulotomy.
内镜下Zenker憩室切开术（EZD）是Zenker憩室（ZD）的主要治疗方法。在EZD过程中，憩室不被切除，术后视频荧光吞咽造影检查（VFSS）的解读具有挑战性。本研究的目的是描述成功进行EZD术后VFSS的正常表现。
提取2011年10月1日至2014年5月30日在本中心接受治疗的所有ZD患者的病历。观察指标包括复发性憩室大小、饮食评估工具-10（EAT-10）、穿透误吸量表、咽缩窄率（PCR）和咽食管段（PES）开口。
20例患者符合纳入标准。平均年龄为70.5（±13）岁。70%的患者为男性。EAT-10平均从17.9（±8.2）降至5（±6.9），下降了72.1%（P<0.0001），憩室大小从1.96 cm（±0.68）降至0.96 cm（±0.57），下降了50.9%（P<0.001）。PCR从0.17（±0.13）提高到0.11（±0.11），提高了33.6%（P<0.001）。PES开口在侧位视图中平均从0.53 cm（±0.3544）增加到0.86 cm（±0.29），增加了61.6%，在前后位视图中从1.00 cm（±0.54）增加到1.39 cm（±0.46），增加了40.0%（P<0.001）。
成功进行EZD术后的VFSS显示憩室大小约减少50%，PCR和PES开口有显著改善。这些数据为成功的憩室切开术的预期荧光造影结果提供了一个框架。
4。《喉镜》，127:1762 - 1766，2017年。
