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Zenker’s Diverticulum

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Principles of Deglutition

Abstract

There is now strong evidence that acquired Zenker’s diverticulum arises in most cases secondary to a poorly compliant, but normally relaxing, UES which cannot fully distend during the process of sphincter opening. This gives rise to increased hypopharyngeal intrabolus pressure during the phase of trans-sphincteric bolus flow; pressure which is imparted to the area of relative muscular weakness (Killian’s dehiscence) just proximal to the cricopharyngeus. This combination of factors gives rise to posterior herniation of the pouch over many years. The restricted opening of the cricopharyngeus is a result of muscle fibre degeneration and fibroadipose tissue replacement. For this reason, cricopharyngeal myotomy is the essential component for successful surgical treatment of the condition. The precise aetiology of this myopathic process affecting the cricopharyngeus is unknown and may be multifactorial. However, an underlying myositis with a predilection for the cricopharyngeus muscle is likely to be one such factor in some cases.

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Author information

Authors and Affiliations

  1. Neurogastroenterology and Motility Service and Swallow Centre, Department of Gastroenterology and Hepatology, St George Hospital, Sydney, Australia

    Ian J. Cook MBBS, MD(Syd), FRACP (Director)

  2. Faculty of Medicine, University of New South Wales, Sydney, Australia

    Ian J. Cook MBBS, MD(Syd), FRACP (Professor of Medicince)

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  1. Ian J. Cook MBBS, MD(Syd), FRACP
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  2. Ian J. Cook MBBS, MD(Syd), FRACP
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Correspondence to Ian J. Cook MBBS, MD(Syd), FRACP .

Editor information

Editors and Affiliations

  1. Div. Gastroenterology & Hepatology, Medical College of Wisconsin, West Wisconsin Avenue 9200, Milwaukee, 53226, Wisconsin, USA

    Reza Shaker

  2. , Dpt Otolaryngology/Head & Neck Surg., UC Davis Medical Center, Stockton Blvd. 2521, Sacramento, 95817, California, USA

    Peter C. Belafsky

  3. Ctr for Voice, Airway & Swallowing Disor, Department of Otolaryngology, Georgia Health Sciences University, 15th Street 1120, Augusta, 30912, Georgia, USA

    Gregory N. Postma

  4. , Dpt of Communication Sciences & Disorder, University of Wisconsin-Milwaukee, East Hartford Ave 2400, Milwaukee, 53201, Wisconsin, USA

    Caryn Easterling

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Cook, I.J., Cook, I.J. (2013). Zenker’s Diverticulum. In: Shaker, R., Belafsky, P., Postma, G., Easterling, C. (eds) Principles of Deglutition. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3794-9_35

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  • DOI: https://doi.org/10.1007/978-1-4614-3794-9_35

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