Dysphagia Outcomes in Zenker Diverticulum: A Longitudinal POuCH Study - PubMed (original) (raw)
. 2026 Feb;136(2):683-687.
doi: 10.1002/lary.70052. Epub 2025 Aug 19.
Mallory McKeon 2, Jacqui Allen 3, Mekibib Altaye 4, Milan R Amin 5, Semirra L Bayan 6, Peter C Belafsky 7, Jonathan M Bock 8, Brad W DeSilva 9, Greg Dion 2, Dale C Ekbom 6, Aaron D Friedman 2, Mark Fritz 10, Elizabeth A Guardiani 11, Christopher Johnson 12, Jan Kasperbauer 6, Brandon Kim 9, Brittany N Krekeler 2, Maggie Kuhn 7, Paul Kwak 5, Yue Ma 13, Lyndsay L Madden 14, Laura Matrka 9, Ross M Mayerhoff 15, Cyrus Piraka 16, Clark Rosen 13, Meredith Tabangin 4, Keith Wilson 2, Vyvy N Young 13, Gregory Postma 12, Rebecca J Howell 2
Affiliations
- PMID: 40828004
- PMCID: PMC12793932
- DOI: 10.1002/lary.70052
Dysphagia Outcomes in Zenker Diverticulum: A Longitudinal POuCH Study
Ari D Schuman et al. Laryngoscope. 2026 Feb.
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 > 24 months (median change -11 [IQR: -14, -7]); 26 (16%) > 36 months (-9.5 [-17, -5]), and 12 (7.5%) > 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.
Keywords: Zenker diverticulum (ZD); quality of life; surgical outcomes; upper esophageal sphincter.
© 2025 The Author(s). The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.
Conflict of interest statement
The authors have nothing to report.
The authors declare no conflicts of interest.
Figures
FIGURE 1
Change in EAT‐10 Score over time. Spaghetti plot showing change in EAT‐10 score over time. Each set of lines and symbols demonstrates the outcomes over time of an individual. [Color figure can be viewed in the online issue, which is available at
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References
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- Wheeler W. I., “Pharyngocele and Dilatation of Pharynx, With Existing Diverticulum at Lower Portion of Pharynx Lying Posterior to the œsophagus, Cured by Pharyngotomy, Being the First Case of the Kind Recorded,” Dublin Journal of Medical Science 82 (1886): 349–356.
- Bock J., Van Daele D., Gupta N., and Blumin J., “Management of Zenker's Diverticulum in the Endoscopic Age: Current Practice Patterns,” Annals of Otology, Rhinology and Laryngology 120, no. 12 (2011): 796–806. -PubMed
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