Dysphagia Outcomes in Zenker Diverticulum: A Longitudinal <scp>POuCH</scp> Study

ABSTRACT Objective Patients with cricopharyngeus muscle dysfunction (CPMD) with and without diverticula (e.g., Zenker Diverticulum) often struggle with dysphagia for years prior to diagnosis or intervention. Surgical treatment is successful; yet, there is limited long‐term data on dysphagia outcomes after surgery. Methods Individuals prospectively enrolled in the Prospective Outcomes of Cricopharyngeal Hypertonicity (POuCH) collaborative with and without diverticula who underwent surgery from November 2014 to August 2024 and had at least 12 months of follow‐up were included. Eating Assessment Tool 10 (EAT10) was used to characterize patient‐reported outcomes. Descriptive statistics were performed using means, frequencies, and spaghetti plots. Results Of 164 patients initially identified, 2 withdrew and 2 were excluded for incomplete data; 160 were included. 31% were women, with a mean (SD) age of 70.1 (11.5). Endoscopic surgery (113, 71%) was more common than open technique (47, 29%). 19.4% of patients had undergone previous surgery. Postoperatively, patients were found to have improved EAT‐10 scores, with smaller changes recorded after 36 months. Median change in EAT‐10 compared to preoperative score was −12 points [IQR: −18, −5] at 12 months. 39 (24%) patients were followed for &gt; 24 months (median change −11 [IQR: −14, −7]); 26 (16%) &gt; 36 months (−9.5 [−17, −5]), and 12 (7.5%) &gt; 48 months (−4 [IQR: −18, 4]). Six patients died during the study period. Conclusion Improved dysphagia after surgery appears stable with minimal change over time. Most patients (96.3%) survive at least 1 year. Surgical intervention for patients with CPMD with or without diverticula is an effective and reliable treatment option. Level of Evidence 4.

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Publication Details

Journal
The Laryngoscope
Published
2025-08-19
DOI
https://doi.org/10.1002/lary.70052
Citations
1
Primary Topic
Dysphagia Assessment and Management
Type
article
Field-Weighted Citation Impact
3.12

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article

Dysphagia Outcomes in Zenker Diverticulum: A Longitudinal POuCH Study

Rebecca J. Howell, Clark A. Rosen, Dale C. Ekbom, Meredith E. Tabangin et al.
1 citations
The Laryngoscope
Dysphagia Assessment and Management
3.12
article

Dysphagia Outcomes in Zenker Diverticulum: A Longitudinal POuCH Study

Rebecca J. Howell, Clark A. Rosen, Dale C. Ekbom, Meredith E. Tabangin, Jonathan M. Bock, Lyndsay L. Madden, Laura Matrka, Aaron D. Friedman, Semirra L. Bayan, Mekibib Altaye, Mark A. Fritz, Paul E. Kwak, Christopher Johnson, Gregory R. Dion, Ari D. Schuman, Milan R. Amin, Ross Mayerhoff, Elizabeth Guardiani, Brad W. deSilva, Gregory N. Postma, Mallory McKeon, Yue Ma, Cyrus Piraka, Maggie A. Kuhn, Jan L. Kasperbauer, VyVy N. Young, Brittany N. Krekeler, Peter C. Belafsky, Jacqueline Allen, Keith Wilson, Brandon Kim
article en
1 citations

Abstract

ABSTRACT Objective Patients with cricopharyngeus muscle dysfunction (CPMD) with and without diverticula (e.g., Zenker Diverticulum) often struggle with dysphagia for years prior to diagnosis or intervention. Surgical treatment is successful; yet, there is limited long‐term data on dysphagia outcomes after surgery. Methods Individuals prospectively enrolled in the Prospective Outcomes of Cricopharyngeal Hypertonicity (POuCH) collaborative with and without diverticula who underwent surgery from November 2014 to August 2024 and had at least 12 months of follow‐up were included. Eating Assessment Tool 10 (EAT10) was used to characterize patient‐reported outcomes. Descriptive statistics were performed using means, frequencies, and spaghetti plots. Results Of 164 patients initially identified, 2 withdrew and 2 were excluded for incomplete data; 160 were included. 31% were women, with a mean (SD) age of 70.1 (11.5). Endoscopic surgery (113, 71%) was more common than open technique (47, 29%). 19.4% of patients had undergone previous surgery. Postoperatively, patients were found to have improved EAT‐10 scores, with smaller changes recorded after 36 months. Median change in EAT‐10 compared to preoperative score was −12 points [IQR: −18, −5] at 12 months. 39 (24%) patients were followed for &gt; 24 months (median change −11 [IQR: −14, −7]); 26 (16%) &gt; 36 months (−9.5 [−17, −5]), and 12 (7.5%) &gt; 48 months (−4 [IQR: −18, 4]). Six patients died during the study period. Conclusion Improved dysphagia after surgery appears stable with minimal change over time. Most patients (96.3%) survive at least 1 year. Surgical intervention for patients with CPMD with or without diverticula is an effective and reliable treatment option. Level of Evidence 4.

The LaryngoscopeVol. 136(2)
University of Maryland, Baltimore (US), Cincinnati Children's Hospital Medical Center (US), Mayo Clinic (US), University of Kentucky (US), Henry Ford Health System (US), University of Auckland (NZ), University of California, San Francisco (US), Baylor College of Medicine (US), Medical College of Wisconsin (US), Augusta University (US), The Ohio State University Wexner Medical Center (US), Cincinnati VA Medical Center (US), Wake Forest University (US), The Ohio State University (US), New York University (US), University of Cincinnati (US), University of California, Davis (US), University of Cincinnati Medical Center (US)
American Laryngological, Rhinological and Otological Society
Openalex Percentile: Top 9%
Dysphagia Assessment and Management
3.12
DOIOpen Access PDFOpenAlex
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