Abstract
Zenker's diverticulum (ZD) is an outpouching of tissue through Killian's triangle thought to be due to cricopharyngeal muscle dysfunction. This relatively uncommon disorder, which occurs more commonly in the elderly, presents with symptoms of dysphagia. Videofluoroscopy confirms the diagnosis. Therapy of symptomatic ZD has evolved from an open surgical approach to transoral endoscopic techniques. Transoral endoscopic therapy includes the rigid approach performed primarily by otorhinolaryngologists and the flexible approach performed by surgical endoscopists and gastroenterologists. The common goal of all treatments is dividing the septum between the esophageal lumen and the diverticular lumen. Each approach has variations in techniques, as well as advantages and disadvantages. In this chapter, we will outline the pathophysiology and management of patients with Zenker's diverticula, with an emphasis on flexible endoscopic therapy.
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