Recurrent Zenker's diverticulum: treatment with crycopharyngeal myotomy.

Recurrence following treatment of Zenker's diverticulum (ZD) occurs in up to 16 per cent of patients. We have reviewed our experience with cricopharyngeal myotomy (CM) to determine its safety and efficacy in the treatment of recurrent ZD. Eight patients were treated, five with early recurrence (symptoms persisting or recurring within 6 months of their initial surgery) and three with late recurrence. Most patients with early recurrence did not have an adequate CM as part of their initial therapy, suggesting that adequate myotomy is important for early relief of dysphagia. Seven patients underwent CM alone, and one patient underwent CM with diverticulectomy. All patients experienced immediate relief of their dysphagia, with good to excellent results persisting at last follow-up (mean follow-up 53 months). Complications were seen only in the patient who underwent combined myotomy with diverticulectomy. We have found CM alone to be quite safe and effective in the treatment of recurrent ZD.