• UCLA Health
  • myUCLAHealth
  • School of Medicine
UCLA Head and Neck Surgery

UCLA Head and Neck Surgery

UCLA Head and Neck Surgery
  • About Us
    • Chair's Welcome
    • Maps and Directions
    • For Referring Physicians
    • News and Events
    • Faculty Recruiting
    • Webinars
    • Donate
    • Contact Us
  • Clinical Services
    • Conditions Treated
    • Airway Stenosis Program
    • Balance Program
    • Beverly Hills Clinic
    • Cochlear Implant Program
    • Endocrine Surgery Program
    • Facial Plastic & Reconstructive Surgery
    • Head and Neck Cancer Program
    • Microvascular and Reconstructive Surgery
    • Minimally Invasive Surgery
    • Nasal and Sinus Disease Program
    • Otology/Neurotology
    • Pediatric Otolaryngology
    • Swallowing Disorders Program
    • Voice Center for Medicine and the Arts
    • Airway Stenosis Program
    • Balance Program
    • Beverly Hills
    • Cochlear Implant Program
    • Endocrine Surgery Program
    • Facial Plastic & Reconstructive Surgery
    • Head and Neck Cancer Program
    • Microvascular and Reconstructive Surgery
    • Minimally Invasive Surgery
    • Nasal and Sinus Disease Program
    • Otology/Neurotology
    • Pediatric Otolaryngology
    • Swallowing Disorders Program
    • Voice Center for Medicine and the Arts
  • Conditions Treated
    • Airway Conditions
    • Head & Neck Oncology Conditions
    • Microvascular & Reconstructive Surgery
    • Nasal & Sinus Conditions
    • Neurotology Conditions
    • Pediatric Head & Neck Conditions
    • Swallowing Conditions
    • Voice Conditions
  • Patient Resources
    • Appointments
    • Patient Stories
    • Patient Education
    • Preparing for Surgery
    • Conditions Treated
    • Find a Doctor
    • Maps and Directions
    • Contact Us
  • Academic Programs
    • Residency Program
    • Fellowship Program
    • Sub-Internship Program
  • Research
    • Research Opportunities for Students
    • Research Labs
    • Lab Safety Resources
  • Contact Us
    • Beverly Hills
  • Our Expert Team
    • Faculty Physicians
    • Staff Physicians
    • Research Faculty
    • Health Psychologists
  • UCLA Health
  • myUCLAHealth
  • School of Medicine

UCLA Head and Neck Surgery

Zenker's Diverticulum

  1. Home
  2. Conditions Treated
  3. Zenker's Diverticulum

Zenker's Diverticulum

Share this

Affiliated: Zenker's Diverticulum | Dysphagia | Swallowing Conditions | Patient Stories

Request An Appointment

What is Zenker's Diverticulum?

Zenker's Diverticulum is an esophageal pouch that develops in the upper esophagus that causes debilitating dysphagia (difficulty swallowing) and regurgitation of food. It is named after Friedrich Albert von Zenker (1825-1898) who in 1877 published a series of patients with this disorder and described its anatomic pathophysiology.

What is the anatomy of Zenker's Diverticulum?

Zenker's Diverticulum develops in an area of the throat called "Killian's Dehiscence". This area is a potential area of muscle weakness between the inferior constrictor muscle and the cricopharyngeus muscle. The full thickness wall of the esophagus forms a pouch at this location. The diverticulum typically is left sided but as it gets larger it forms in a central posterior location.

Zenker's Diverticulum
Mid-esophageal diverticulum
Killian-Jamieson (KJ) diverticulum

 

How is Zenker's Diverticulum Diagnosed?

The Head and Neck Surgeons at the UCLA Swallowing Disorders Center will diagnose Zenker's diverticulum based on a combination of your dysphagia history as well as swallow evaluation tests such as barium esophagram, videofluoroscopic swallow study, fiberoptic endoscopic evaluation of swallowing (FEES), and transnasal esophagoscopy.

With these techniques the diagnosis can be made with 100% accuracy. It is very important to distinguish a Zenker's diverticulum from a Mid-esophageal diverticulum or a Killian-Jamieson (KJ) diverticulum. Office-based transnasal esophagoscopy is often used to distinguish between these possibilities if diagnosis is unclear based on radiological studies.

 

Presenting Symptoms and Zenker’s Diverticulum Size

  • The distribution of presenting symptoms across size groups is presented in Table 1.
  • In our published experience the following presenting symptoms were found.
  • Results are presented based on size of the diverticulum (Small < 1 cm, Medium 2-3 cm, Large > 3 cm).
Table 1 Small Medium Large All
  % n % n % n % n
Solid dysphagia 83.3 5 100.0 26 100.0 17 98.1 51
Liquid dysphagia 16.7 1 34.6 9 23.5 4 30.8 16
Regurgitation 16.7 1 68.0 17 68.0 17 64.7 33
Aspiration 16.7 1 19.2 5 5.9 1 13.5 7
Globus 33.3 2 11.5 3 0.0 0 9.6 5
Chronic cough 83.3 5 42.3 11 41.2 7 46.2 24
Weight loss 16.7 1 30.8 8 29.4 5 28.8 15
Gastrostomy tube or total parenteral nutrition 0.0 0 0.0 0 11.8 2 3.8 2

How is Zenker's Diverticulum Treated?

Contemporary treatment of Zenker's diverticulum involves an "endoscopic approach" and division of the common party wall between the esophagus and diverticulum. Endoscopic approach refers to the approach to the diverticulum through the mouth. An "open approach", where an incision is made on the neck to expose and remove the diverticulum is rarely necessary.

Endoscopic View of Zenker's Pouch During SurgeryEndoscopic View of Zenker's Pouch During Surgery.

The success of the endoscopic approach is highly dependent on the experience of the surgeon.

Endoscopic surgery generally leads to a shorter hospital stay and an earlier time to resuming food by mouth. In addition, laser surgery is able to completely divide more of the common party wall as compared to the endoscopic stapling techniques.

Image: Endoscopic Treatment of Zenker's Diverticulum

The goal is to divide the party wall and perform a diverticulotomy; Zenker's sac persists (NOT resected) but food is now able to drain into the esophagus without collecting in the pouch.

What is UCLA's experience with treatment of Zenker's Diverticulum surgery?

The UCLA Swallowing Disorders Center is at the forefront of diagnosis and surgical treatment of Zenker's Diverticulum. The Center recently published its experience in 46 patients treated during a 6 year period.


Publications & Articles

What Is the Best Technique for Diagnosing Esophageal Diverticulum? >
Featuring Dr. Dinesh Chhetri (ENT Today)

Dysphagia Characteristics in Zenker’s Diverticulum >
Jennifer L. Bergeron, MD, Jennifer L. Long, MD, PhD, Dinesh K. Chhetri, MD (journals.sagepub.com)


More Swallowing Conditions >

Appointments

Like Us on Facebook Follow Us on Twitter Subscribe to Our Videos on YouTube Follow us on Instagram Connect with Us on LinkedIn Follow us on Pinterest
UCLA Health hospitals ranked best hospitals by U.S. News & World Report
  • UCLA Health
  • Find a Doctor
  • School of Medicine
  • School of Nursing
  • UCLA Campus
  • Directory
  • Newsroom
  • Subscribe
  • Patient Stories
  • Giving
  • Careers
  • Volunteer
  • International Services
  • Privacy Practices
  • Nondiscrimination
  • Billing
  • Health Plans
  • Emergency
  • Report Broken Links
  • Terms of Use
  • 1-310-825-2631
  • Maps & Directions
  • Contact Us
  • Your Feedback
  • Report Misconduct
  • Get Social
  • Sitemap
Like Us on Facebook Follow Us on Twitter Subscribe to Our Videos on YouTube Follow us on Instagram Connect with Us on LinkedIn Follow us on Pinterest

Sign in to myUCLAhealth