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Year: 2002  Vol. 6   Num. 2  - Apr/June Print:
Original Article
Texto Text in Portuguese
Hipopharyngeal Diverticulum or Zenker´s Diverticulum
Divertículo de Hipofaringe ou de Zenker
José Antônio Pinto*, Gustavo J. Faller**, Roberto D. P. Ferreira**, Rubens H. da Silva**.
Key words:
Hipopharyngeal diverticulum, dysphagy, diverticulotomy, cricopharyngeal miotomy, endoscopy.

Introduction: The hipopharyngeal diverticulum, also known as Zenker´s diverticulum, is a pulsion diverticulum. There is a mucosal herniation through a fragile area of the posterior pharyngeal wall. Its physiopathology is still unclear. The main clinical features are dysphagia and regurgitation, mainly in elderly people. The radiological methods confirm the clinical suspect and show the diverticular pouch. The surgical treatment is performed to relieve the symptoms like dysphagia and to prevent aspiration. Objective: The authors argue the different surgical techniques, indications, complications and outcomes. Methods: Seventeen subjects with Zenker´s diverticulum were analyzed from 1982 to 2000. The surgical procedure was chosen according to the size of the diverticulum, the patient’s clinical conditions and the surgeon’s experience. Results: In these series, 13 patients underwent an external one-stage diverticulotomy with cricopharyngeal muscle miotomy and 4 underwent the Dohlman endoscopic technique. All patients showed improvement in their symptoms. Complications occurred only in the external approach, but had a good resolution. Conclusion: The selection of the surgical technique depends on the patient clinical condition, age, diverticulum size and the surgeon experience, but both techniques showed similar results when well indicated..



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