Surgical Outcomes in Zenker Diverticula: A Multicenter, Prospective, Longitudinal Study

Rebecca Howell, Christopher Johnson, Jacqui Allen, Mekibib Altaye, Milan Amin, Semirra Bayan, Peter Belafsky, Brian Cervenka, Brad Desilva, Gregory R. Dion, Dale Ekbom, Aaron Friedman, Mark Fritz, John Paul Giliberto, Elizabeth Guardiani, Jan Kasperbauer, Brandon Kim, Brittany N. Krekeler, Maggie Kuhn, Paul KwakYue Ma, Lyndsay L. Madden, Laura Matrka, Ross Mayerhoff, Mallory McKeon, Cyrus Piraka, Clark A. Rosen, Meredith Tabangin, Shaun A. Wahab, Keith Wilson, Carter Wright, Vy Vy N. Young, Gregory Postma

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objective: To compare improvement in patient-reported outcomes (PROM) in persons undergoing endoscopic and open surgical management of Zenker diverticula (ZD). Methodology: Prospective, multicenter cohort study of all individuals enrolled in the Prospective OUtcomes of Cricopharyngeus Hypertonicity (POUCH) Collaborative who underwent surgery for ZD. Patient survey, radiography reports, and the 10-item Eating Assessment Tool (EAT-10) pre- and post-procedure were abstracted from a REDCap database, which summarized means, medians, percentages, and frequencies of. Outcome based on operative intervention (endoscopic vs. open) was compared using t-test, Wilcoxon rank sum test or chi-square test, as appropriate. Results: One hundred and forty-seven persons were prospectively followed. The mean age (SD) of the cohort was 68.7 (11.0). Overall, 66% of patients reported 100% improvement in EAT-10; 81% of patients had greater than 75% improvement; and 88% had greater than 50% improvement. Endoscopic was used for n = 109 patients, and open surgical intervention was used for n = 38. The median [interquartile range, IQR] EAT-10 percent improvement for endoscopic treatment was 93.3% [72, 100], and open was 100% [92.3, 100] (p = 0.05). The incidence of intraoperative complications was 3.7% for endoscopic and 7.9% for open surgical management. The median [IQR] in follow-up was 86 and 97.5 days, respectively. Conclusion: Both endoscopic and open surgical management of ZD provide significant improvement in patient-reported outcomes. The data suggest that open diverticulectomy may provide a modest advantage in symptomatic improvement compared to endoscopic management. The data suggest that the postoperative complication rate is higher in the open surgical group. Level of Evidence: 3 Laryngoscope, 134:97–102, 2024.

Original languageEnglish
Pages (from-to)97-102
Number of pages6
Issue number1
StatePublished - Jan 2024

Bibliographical note

Publisher Copyright:
© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.


  • CPMD
  • Zenker
  • cricopharyngeal bar
  • cricopharyngeal dysfunction
  • cricopharyngeus muscle dysfunction
  • hypopharyngeal diverticulum
  • pharyngoesophageal dysphagia

ASJC Scopus subject areas

  • Otorhinolaryngology


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