Radiographic findings and complications after surgical or endoscopic repair of Zenker's diverticulum in 16 patients

OBJECTIVE. The purpose of our study was to reassess the radiographic findin gs and complications associated with surgical or endoscopic repair of Zenke r's diverticulum. MATERIALS AND METHODS. Sixteen patients who underwent various procedures fo r repair of Zenker's diverticulum (diverticulectomy and cricopharyngeal myo tomy in [n = 8], diverticulopexy and cricopharyngeal myotomy [n = 4], endos copic stapling diverticulotomy [n = 3], and cricopharyngeal myotomy alone [ n = 1]) had radiographic studies with water-soluble contrast material, bari um, or both during the early postoperative period (n = 7), late postoperati ve period (n = 4), or both (n = 5). The radiologic reports and images were reviewed to determine the postoperative findings and complications associat ed with surgical or endoscopic repair of Zenker's diverticulum. RESULTS. Radiographic studies revealed leaks during the early postoperative period in three (27%) of 11 patients after surgical repair of Zenker's div erticulum and in zero of three patients after endoscopic diverticulotomy. P haryngeal dysfunction (pharyngeal paresis, decreased epiglottic tilt, laryn geal penetration, or tracheobronchial aspiration) was detected in seven (54 %) of 13 patients after surgery and in one (33%) of three patients after en doscopic diverticulotomy; five of these eight patients had follow-up barium studies during the late postoperative period, and all five showed marked i mprovement in pharyngeal function. An extrinsic cricopharyngeal impression was detected in six (38%) of these 16 patients, a remnant diverticulum in f our (25%), and mucosal beaking in three (19%). A suspended or inverted dive rticulum. was detected in one of the four patients who underwent surgical d iverticulopexy. CONCLUSION. Radiologists should be aware of the various postoperative findi ngs and complications associated with surgical or endoscopic repair of Zenk er's diverticulum so that appropriate interventions can be taken in patient s with this condition.