Normal fluoroscopic appearance status post-successful endoscopic Zenker diverticulotomy

Naren N. Venkatesan, Lisa M. Evangelista, Maggie Kuhn, Peter C Belafsky

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: Endoscopic Zenker diverticulotomy (EZD) is a primary treatment for Zenker diverticulum (ZD). During EZD, the diverticulum is not excised, and interpretation of postoperative videofluoroscopic swallow study (VFSS) is challenging. The purpose of this investigation was to describe normal VFSS findings status post-successful EZD. Methods: The charts of all patients with ZD treated at our center between October 01, 2011, and May 30, 2014, were abstracted. Outcome measures included recidivistic diverticulum size, Eating Assessment Tool-10 (EAT-10), penetration aspiration scale, pharyngeal constriction ratio (PCR), and pharyngoesophageal segment (PES) opening. Results: Twenty patients met inclusion criteria. The mean age was 70.5 (± 13) years. Seventy percent of the patients were male. Mean EAT-10 decreased 72.1% from 17.9 (± 8.2) to 5 (± 6.9) (P < 0.0001), and diverticulum size decreased 50.9% from 1.96 cm (± 0.68) to 0.96 cm (± 0.57) (P < 0.001). The PCR improved 33.6% from 0.17 (± 0.13) to 0.11 (± 0.11) (P < 0.001). Mean PES opening increased 61.6% from 0.53 cm (± 0.3544) to 0.86 cm (± 0.29) in lateral view and increased 40.0% from 1.00 cm (± 0.54) to 1.39 cm (± 0.46) in anteroposterior view (P < 0.001). Conclusion: VFSS following successful EZD demonstrates an approximate 50% reduction in diverticulum size and significant improvement in PCR and PES opening. These data provide a framework for the expected fluoroscopic outcomes of successful diverticulotomy.

Original languageEnglish (US)
JournalLaryngoscope
DOIs
StateAccepted/In press - 2017

Fingerprint

Diverticulum
Deglutition
Zenker Diverticulum
Constriction
Eating
Outcome Assessment (Health Care)
Therapeutics

Keywords

  • Dysphagia
  • Endoscopic diverticulotomy
  • Fluoroscopy
  • Zenker diverticulum

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Normal fluoroscopic appearance status post-successful endoscopic Zenker diverticulotomy. / Venkatesan, Naren N.; Evangelista, Lisa M.; Kuhn, Maggie; Belafsky, Peter C.

In: Laryngoscope, 2017.

Research output: Contribution to journalArticle

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abstract = "Objective: Endoscopic Zenker diverticulotomy (EZD) is a primary treatment for Zenker diverticulum (ZD). During EZD, the diverticulum is not excised, and interpretation of postoperative videofluoroscopic swallow study (VFSS) is challenging. The purpose of this investigation was to describe normal VFSS findings status post-successful EZD. Methods: The charts of all patients with ZD treated at our center between October 01, 2011, and May 30, 2014, were abstracted. Outcome measures included recidivistic diverticulum size, Eating Assessment Tool-10 (EAT-10), penetration aspiration scale, pharyngeal constriction ratio (PCR), and pharyngoesophageal segment (PES) opening. Results: Twenty patients met inclusion criteria. The mean age was 70.5 (± 13) years. Seventy percent of the patients were male. Mean EAT-10 decreased 72.1{\%} from 17.9 (± 8.2) to 5 (± 6.9) (P < 0.0001), and diverticulum size decreased 50.9{\%} from 1.96 cm (± 0.68) to 0.96 cm (± 0.57) (P < 0.001). The PCR improved 33.6{\%} from 0.17 (± 0.13) to 0.11 (± 0.11) (P < 0.001). Mean PES opening increased 61.6{\%} from 0.53 cm (± 0.3544) to 0.86 cm (± 0.29) in lateral view and increased 40.0{\%} from 1.00 cm (± 0.54) to 1.39 cm (± 0.46) in anteroposterior view (P < 0.001). Conclusion: VFSS following successful EZD demonstrates an approximate 50{\%} reduction in diverticulum size and significant improvement in PCR and PES opening. These data provide a framework for the expected fluoroscopic outcomes of successful diverticulotomy.",
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AU - Evangelista, Lisa M.

AU - Kuhn, Maggie

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N2 - Objective: Endoscopic Zenker diverticulotomy (EZD) is a primary treatment for Zenker diverticulum (ZD). During EZD, the diverticulum is not excised, and interpretation of postoperative videofluoroscopic swallow study (VFSS) is challenging. The purpose of this investigation was to describe normal VFSS findings status post-successful EZD. Methods: The charts of all patients with ZD treated at our center between October 01, 2011, and May 30, 2014, were abstracted. Outcome measures included recidivistic diverticulum size, Eating Assessment Tool-10 (EAT-10), penetration aspiration scale, pharyngeal constriction ratio (PCR), and pharyngoesophageal segment (PES) opening. Results: Twenty patients met inclusion criteria. The mean age was 70.5 (± 13) years. Seventy percent of the patients were male. Mean EAT-10 decreased 72.1% from 17.9 (± 8.2) to 5 (± 6.9) (P < 0.0001), and diverticulum size decreased 50.9% from 1.96 cm (± 0.68) to 0.96 cm (± 0.57) (P < 0.001). The PCR improved 33.6% from 0.17 (± 0.13) to 0.11 (± 0.11) (P < 0.001). Mean PES opening increased 61.6% from 0.53 cm (± 0.3544) to 0.86 cm (± 0.29) in lateral view and increased 40.0% from 1.00 cm (± 0.54) to 1.39 cm (± 0.46) in anteroposterior view (P < 0.001). Conclusion: VFSS following successful EZD demonstrates an approximate 50% reduction in diverticulum size and significant improvement in PCR and PES opening. These data provide a framework for the expected fluoroscopic outcomes of successful diverticulotomy.

AB - Objective: Endoscopic Zenker diverticulotomy (EZD) is a primary treatment for Zenker diverticulum (ZD). During EZD, the diverticulum is not excised, and interpretation of postoperative videofluoroscopic swallow study (VFSS) is challenging. The purpose of this investigation was to describe normal VFSS findings status post-successful EZD. Methods: The charts of all patients with ZD treated at our center between October 01, 2011, and May 30, 2014, were abstracted. Outcome measures included recidivistic diverticulum size, Eating Assessment Tool-10 (EAT-10), penetration aspiration scale, pharyngeal constriction ratio (PCR), and pharyngoesophageal segment (PES) opening. Results: Twenty patients met inclusion criteria. The mean age was 70.5 (± 13) years. Seventy percent of the patients were male. Mean EAT-10 decreased 72.1% from 17.9 (± 8.2) to 5 (± 6.9) (P < 0.0001), and diverticulum size decreased 50.9% from 1.96 cm (± 0.68) to 0.96 cm (± 0.57) (P < 0.001). The PCR improved 33.6% from 0.17 (± 0.13) to 0.11 (± 0.11) (P < 0.001). Mean PES opening increased 61.6% from 0.53 cm (± 0.3544) to 0.86 cm (± 0.29) in lateral view and increased 40.0% from 1.00 cm (± 0.54) to 1.39 cm (± 0.46) in anteroposterior view (P < 0.001). Conclusion: VFSS following successful EZD demonstrates an approximate 50% reduction in diverticulum size and significant improvement in PCR and PES opening. These data provide a framework for the expected fluoroscopic outcomes of successful diverticulotomy.

KW - Dysphagia

KW - Endoscopic diverticulotomy

KW - Fluoroscopy

KW - Zenker diverticulum

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