RECURRENT ZENKERS-DIVERTICULUM - TREATMENT WITH CRICOPHARYNGEAL MYOTOMY

Recurrence following treatment of Zenker's diverticulum (ZD) occurs in up to 16 per cent of patients. We have reviewed our experience with c ricopharyngeal myotomy (CM) to determine its safety and efficacy in th e treatment of recurrent ZD. Eight patients were treated, five with ea rly recurrence (symptoms persisting or recurring within 6 months of th eir initial surgery) and three with late recurrence, Most patients wit h early recurrence did not have an adequate CM as part of their initia l therapy, suggesting that adequate myotomy is important for early rel ief of dysphagia. Seven patients underwent CM alone, and one patient u nderwent CM with diverticulectomy. All patients experienced immediate relief of their dysphagia, with good to excellent results persisting a t last follow-up (mean follow-up 53 months). Complications were seen o nly in the patient who underwent combined myotomy with diverticulectom y. We have found CM alone to be quite safe and effective in the treatm ent of recurrent ZD.