Diagnosis and treatment of diverticulums in laryngopharynx and cervical esophagus

Abstract

To explore the clinical presentations, diagnosis and treatment of diverticulums in laryngopharynx and cervical esophagus. Nineteen cases of diverticulums in laryngopharynx and cervical esophagus with general clinical information available from 1985 to 2010 at Peking Union Medical College Hospital were reviewed retrospectively and analyzed with a literature review. One case of lateral hypopharyngeal pouch presented with fetor oris and pharyngalgia. Three cases of Killian-Jamieson diverticulums had fetor oris and dysphagia. Among 15 cases of Zenker diverticulums, 3 had fetor oris, sour regurgitation and dysphagia while another 12 cases were asymptomatic. Seven patients with subjective complaints underwent diverticulectomy through open surgeries or endoluminal approaches and their symptoms were resolved and no recurrences were found during a follow-up period of 6 months-18 years. In 12 cases of asymptomatic Zenker diverticulums, observation was adopted and there was no complaint during a follow-up period of 1 - 25 years. Lateral hypopharyngeal pouch, Killian-Jamieson diverticulum and Zenker's diverticulum are rare entities with different clinical presentations. For symptomatic diverticulum, the most common treatment is surgical resection of diverticulectom and the prognosis is satisfactory. But for asymptomatic diverticulum, observation suffices.