Pharyngeal pouch surgery - NEW (2023)

A pharyngeal pouch, also known as Zenker’s diverticulum, is a sac or pocket which can develop between the lower part of the throat (pharynx) and the upper part of the gullet or food pipe (oesophagus). It is a rare condition.

This condition is diagnosed on a barium swallow scan. This is an x-ray taken while swallowing a dye which coats the lining of the throat and food pipe.

The cause of a pharyngeal pouch is not clear, but it tends to form in an area of natural weakness in the muscle of the lower throat. It may develop due to muscle spasm and poor coordination of the muscles at the entrance of the food pipe. In some patients, there may also be a link between acid reflux and a pharyngeal pouch forming.

A very small pouch may not cause any symptoms, or it may create the occasional sensation of food sticking in the lower part of the throat. These symptoms can be monitored by your GP. If they get worse, your GP will refer you to an ENT specialist.

If the pharyngeal pouch gets larger, it starts to collect food within it, putting pressure on the entrance to the food pipe and making it difficult to swallow. This is called dysphagia, which is the commonest symptom. Severe swallowing difficulty may cause weight loss. Your surgeon may want to run some tests to exclude other causes of weight loss.

Figure 1. An illustration of the position of a pharyngeal pouch and what symptoms it may cause.

Most people with this condition will sometimes bring back up undigested food which has been sitting in the pouch. A chronic cough and choking sensation may be a symptom of small amounts of liquid and food, which have been sitting in the pouch, spilling into the windpipe (trachea). Less frequently, this can also cause recurrent chest infections. In these situations, your surgeon will discuss whether surgery is appropriate for you.

What is the benefit of having surgery?

The aim of surgery on a pharyngeal pouch is to make it easier to swallow food. You may have been losing weight if you have not been able to eat enough. If food spilling out of the pouch and into your windpipe has caused a lot of chest infections, operating will prevent these.

What is pharyngeal pouch repair surgery?

Patients with symptoms may require surgery. There are two main ways of treating pouches. Endoscopic surgery is the commonest and least risky approach, and open surgery, which is slightly riskier and requires a longer hospital stay. Both operations are performed under a general anaesthetic, so the patient is asleep.

An endoscope (a rigid metal tube) is passed through the mouth into the throat until it reaches the pouch. The wall between the pouch and the food pipe is stapled and cut using a special stapler, which releases the tight muscle. This is called endoscopic pharyngeal pouch stapling. You usually can go home on the same day as this procedure.

A laser may be used as well as or instead of a stapler. This may be used to divide the muscle of the pouch. This is called an endoscopic laser cricopharyngeal myotomy. After this operation, the patient needs to be kept in hospital for an average of two to five days and fed with a feeding tube. An x-ray is needed to make sure that the food pipe has healed. As with all lasers, there is a risk of fire.

(Video) Online session-The pharyngeal pouch-Prof Dr Qotb

To help manage symptoms from smaller pouches, some specialists may offer Botox injections, in which a muscle relaxant is injected into the tight throat muscle. Another option is balloon dilatation, in which a small balloon is expanded to stretch the muscle.

Are there any alternative treatments?

Flexible endoscopic pharyngeal pouch repair

This approach has not been adequately evaluated in the UK for patient safety and is not offered by any otolaryngologist at present.

Open pharyngeal pouch repair

Around one in ten patients are unable to have endoscopic pharyngeal pouch repair. This may be because they cannot open their mouths wide enough, or their neck is too stiff to allow the endoscope to reach the pouch. Sometimes, the pouch is too big for this operation to be done through the mouth. In these situations, the surgeon will advise that open pharyngeal pouch repair is needed. The surgeon will first try to perform this operation using an endoscope, but if they cannot reach the pouch, may recommend that you have open pharyngeal pouch repair during the same anaesthetic. This is a longer procedure and needs a longer stay in hospital. You may wish to be woken up and have a think about whether you want to have the open procedure.

An open approach involves making a cut through the skin on the side of the neck. The neck is opened, the pouch is found and removed, and the tight muscle is released. The food pipe is then repaired and the wound stitched closed. If your general health is not very good you may not be fit enough to have this operation.

What will happen if I do not have the operation?

You will continue to have symptoms. You may get chest infections that keep coming back. If you become unable to swallow anything, you may require other methods of feeding, such as a feeding tube in the stomach.

WHAT ARE THE RISKS?

Are there any risks to this operation?

All operations have an intended benefit but also have risks.

Risks are grouped into the following categories:

Pharyngeal pouch surgery - NEW (1)Pharyngeal pouch surgery - NEW (2)

Most patients make a quick recovery, and the risk of difficulties is low. Potential problems include the following:

(Video) What is a pharyngeal pouch? - Online interview

Damage to the lips and teeth.

Because the endoscope is a rigid metal tube, it can put some pressure on the teeth, lips, gums and tongue. For patients with large or loose teeth or those with caps or crowns, there is a small risk of damage (2% to 5%). The risk is greater if patients have a small mouth or cannot open their mouth very wide.

Sore throat.

The operation involves cutting some muscles in your throat, so this area may be sore for a little while. Taking painkillers regularly should ease the pain.

Infection.

The risk of infection to the area is low (1% to 2%). You will not routinely be prescribed a course of antibiotics after this operation.

Bleeding.

The risk of bleeding is low (less than 1%). If there is bleeding, you may see fresh blood in your saliva. It is very rare that a patient has to come back to the operating theatre to stop the bleeding.

Throat or food pipe tear.

Tearing can occur due to the position of the pouch. The wall of the pouch can also be very thin. The risk is the same whether an endoscopic stapler or a laser is used. The risk is small (just over 2%), but if a tear does occur, it can be very serious. A course of antibiotics will be required. You will need to be fed through a feeding tube and observed in hospital for an average of five to seven days. Most small tears heal on their own, but large tears may require further operations.

Chest problems.

(Video) Open Repair of Zenker's Diverticulum

If there is a throat or food pipe tear, patients may experience inflammation and infection of the tissues surrounding the food pipe. This is called mediastinitis and is a rare but very serious complication. Patients will require treatment with antibiotics and a longer stay in hospital. Rarely, patients may be transferred to the cardiothoracic unit for repair of the food pipe tear.

Swallowing difficulties.

These are not uncommon during the first few days as the tissues heal. If these symptoms persist, it may mean that the base of the pouch (which is often left to reduce the chance of a food pipe tear) is still large enough to cause problems. Or it could mean that the pouch has re-formed, or that there is excessive scar tissue in the area.

Possible problems of open pouch repair

The risk of infecting the tissues around the food pipe is higher (just over 1% ) during open pouch repair than with an endoscope or laser (less than 1%). A connection between the skin and the deeper tissues (called a fistula) is common and can affect just over one in ten people who have open surgery. Fistulas usually heal.

The nerve to the voice box (called the laryngeal nerve) can also be bruised or damaged, as it lies right next to the pouch (just over 12%). This may cause a weak or hoarse voice.

General anaesthetic

The operation is performed under general anaesthetic. Problems can include blood clots in the legs (called deep vein thrombosis) or lungs (called pulmonary embolism), heart attack, chest infection, stroke, and death. These complications are all rare. However, some patients have other medical conditions that make them more likely and increase the risks of a general anaesthetic.

The pre-assessment team and anaesthetist will explain what occurs during a general anaesthetic and the associated risks that are relevant to you. This link summarises the common events and risks of a general anaesthetic.

WHAT HAPPENS AFTER MY OPERATION?

What happens after the operation?

After the operation, you will be moved to the recovery area. When your anaesthetic has worn off, you will be taken back to the ward.

When can I eat after this surgery?

Some surgeons will advise you not to eat or drink for a few hours (sometimes until the next day). You will be fed through a nasogastric feeding tube for one or two days. This is a thin tube inserted through your nostril and down into your stomach. You may be given fluid through a vein. For open pharyngeal pouch surgery, most surgeons place feeding tubes until the lining has healed. If you had an endoscopic repair, you would eat on the same day.

(Video) Pharyngology P4 pharyngeal pouch

When your surgeon is satisfied there is no risk of leakage, liquids and food will be gradually introduced. You may need a swallow test, where an x-ray is taken while you swallow a dye that coats the lining of the throat and food pipe. This will show us if the food pipe has healed. If it has, you will gradually be able to eat soft foods and drink fluids again. To allow the area to heal properly, it is recommended to have a day or two of liquids, followed by a few days of soft food, while slowly adding more solid food. It normally takes around a week before the soreness goes and patients can eat most things. A dietician will usually see you to give you advice.

Will I have a drain in my neck?

If you have an open approach, you will have a neck drain. This is removed once the surgeon is satisfied with the wound’s progress. The nursing staff will monitor your neck and drain overnight.

How long will I stay in hospital?

You will be discharged once your surgeon is satisfied that there is no leak, that your throat is comfortable and that you are managing enough liquids and food by mouth.

After an endoscopic pharyngeal pouch operation, patients are either discharged on the same day or stay overnight for 24 hours. After open pharyngeal pouch surgery, the length of stay is longer, usually between five and seven days.

If for any reason, there is a problem following surgery, then you might need to stay in hospital for longer.

What is the recovery period?

We recommend a couple of weeks to recover from this surgery.

Will the pharyngeal pouch come back?

All techniques used to treat a pharyngeal pouch carry a small risk of the symptoms coming back (roughly one out of ten). Some techniques, such as Botox injection and expanding a balloon to stretch the muscle, may be linked to symptoms coming back more often.

Most surgeons will judge whether surgery was successful by what the patient says about changes in swallowing, weight gain and chest infections. They do not tend to re-scan patients after surgery to check for any remaining signs of pharyngeal pouch. They will only investigate further if a patient still shows symptoms, or if their symptoms get worse. Most surgeons performing pharyngeal pouch surgery will be collecting information and auditing their results.

Will I have a follow-up appointment?

You will be advised by your surgical team.

PHARYNGEAL POUCH QUICK FACTS

  • Can affect people who are 70 years old and older. Affects one person in 100,000 per year.
  • Males are affected more than females. Three males are affected for every two females affected.
  • Symptoms include: difficulty swallowing,coughing after eating, regurgitation of food, chest infections.
  • Abnormal cells may be present in the pouch. This can affect one person out of 200 people who have a pouch.
  • Pouches can be left alone if small and not causing problems. Most operations to treat pouches can be performed through the mouth. Some pouches may need an operation through a cut in the neck.
  • An important complication to know about is mediastinitis. This is an infection inside your chest between the heart and the lungs. This is rare, but very serious if it occurs.

Authors: May Yaneza, Nashreen Oozeer

Disclaimer: This publication is designed for the information of patients. Whilst every effort has been made to ensure accuracy, the information contained may not be comprehensive and patients should not act upon it without seeking professional advice.

(Video) PHARYNGEAL POUCH: DIFFICULT INTUBATION

FAQs

What is the treatment for pharyngeal pouch? ›

The traditional treatment for pharyngeal pouch involves open surgery to the neck. Open diverticulectomy involves complete removal of the pouch. Alternatively, the muscle responsible for pouch formation may be divided (sometimes combined with inversion or invagination of the pouch).

Is pharyngeal pouch serious? ›

A pharyngeal pouch is like a hernia at the top of your oesophagus. They usually grow slowly and it can be many years before patients realise they have problems. While some pouches do not cause any problems, some can cause difficulty swallowing, regurgitation of food and lead to chest infections.

Can you feel a pharyngeal pouch? ›

A pharyngeal pouch is bulge or pocket that develops in the top of your oesophagus. It usually occurs in older patients. Symptoms of a pharyngeal pouch can include a feeling of a lump in your throat, difficulty swallowing (dysphagia), bringing up food after a meal and bad breath.

Is pharyngeal pouch same as Zenker's diverticulum? ›

What is Zenker's diverticulum (pharyngeal pouch) (ZD)? Zenker's diverticulum is a rare, benign condition. In this condition, a large sac develops in the upper part of the oesophagus (gullet/food pipe), known medically as a pharyngeal pouch.

How common is a pharyngeal pouch? ›

A pharyngeal pouch, also known as Zenker's diverticulum, is a sac or pocket which can develop between the lower part of the throat (pharynx) and the upper part of the gullet or food pipe (oesophagus). It is a rare condition.

What happens after Zenker's diverticulum surgery? ›

Diet: Once you are discharged you need to eat a mechanical soft diet. This includes any food, like pasta, fish, mashed potatoes that does not need to be cut or chewed. Swallowing may be more difficult after surgery for the first 2 to 4 weeks due to swelling in your throat.

How many pharyngeal pouches are there? ›

There are six pharyngeal pouches in mammals and birds. Humans have four pharyngeal pouches, as the fifth and sixth pharyngeal pouches are comprised within the fourth pharyngeal pouch. Pharyngeal pouch development is hypothetically independent of neural crest migration towards the endoderm.

Can Zenker's diverticulum be cured? ›

Zenker's diverticula are normally not treated unless they cause symptoms. Symptomatic diverticula are usually treated by surgery. The surgeon cuts the muscle between the throat and esophagus and removes the pouch.

Does pharyngeal pouch cause dysphagia? ›

A pharyngeal pouch is an important cause of dysphagia in older patients that can present with a variety of symptoms (including chest infections, weight loss and halitosis). The gold standard investigation for a pharyngeal pouch is a barium swallow test.

Is Zenker's diverticulum cancerous? ›

Zenker's diverticulum (ZD) has been increasingly recognized as a site of primary epithelial malignancy.

How do you get food out of Zenker's diverticulum? ›

Endoscopic Zenker's diverticulum surgery is recommended for severe cases. During this procedure, the cricopharyngeal muscle is cut using a laser or stapler. This eliminates the pouch and allows food to pass through when swallowed. Surgery can be performed using either a minimally invasive or open approach.

What causes food pockets in throat? ›

When the lower esophageal muscle (sphincter) doesn't relax properly to let food enter the stomach, it can cause food to come back up into the throat. Muscles in the wall of the esophagus might be weak as well, a condition that tends to worsen over time.

Is Zenker diverticulum precancerous? ›

Abstract. Background: Pharyngeal diverticulum or Zenker's diverticulum carcinoma is a rare malignancy with a poor prognosis. Carcinoma arising in a recurrent pharyngeal diverticulum is even rarer, with only 1 such case reported in the English-language literature.

How serious is Zenker's diverticulum? ›

If left untreated, Zenker's diverticulum can increase in size, making your symptoms worse. Over time, severe symptoms such as difficulty swallowing and regurgitation can make it difficult to stay healthy. You might experience malnutrition. Aspiration is a symptom of Zenker's diverticulum.

What is the most common presentation of a patient with a Zenker diverticulum? ›

Patients with Zenker diverticulum will typically present with a long history of dysphagia followed by a sensation of food stuck in the throat. Up to 98% of patients have the primary complaints of dysphagia. Other common symptoms include recurrent coughing, fetor ex ore (halitosis), and unexplained weight loss.

How is pharyngeal pouch diagnosis? ›

Medical tests to diagnose pharyngeal pouch

To determine if your symptoms are caused by pharyngeal pouch or another condition, your specialist may recommend specific tests such as a diagnostic endoscopy or a barium x-ray test – an x-ray with a white liquid that shows clearly in x-ray scans.

What is pharyngeal pouch stapling? ›

Endoscopic stapling of pharyngeal pouch involves stapling of the opening of the pharyngeal pouch through a specially designed endoscope, under general anaesthetic.

What is a pocket in the throat called? ›

Zenker's diverticulum is more common in men than women, and largely confined to older adults over the age of 50.

Can Zenker's diverticulum come back after surgery? ›

While surgery is usually the best course of action for treating Zenker's diverticulum, it's important to know that there is a chance that the pouch may return. Around 4% of people who had surgery reported that their pouch came back over time.

How long is recovery from Zenker's diverticulum? ›

Recovery from Endoscopic Laser Treatment of Zenker's Diverticulum. Recovery from the endoscopic technique is relatively simple. Patients are discharged home the next morning and must follow a liquid diet for one week, then a soft diet for the second week, after which they are able to start a regular diet. Dr.

What kind of doctor treats Zenker's diverticulum? ›

What Are the Treatment Options? If you have any of the symptoms mentioned here, you should be examined by an ENT (ear, nose, and throat) specialist, or otolaryngologist. Your ENT specialist may diagnose your condition using a “barium swallow” study.

What is the fate of the 5th pharyngeal pouch? ›

Fifth pouch

Rudimentary structure, becomes part of the fourth pouch contributing to thyroid C-cells.

Do pharyngeal pouches become gills? ›

The lateral pockets of the pharyngeal cavity, called the pharyngeal pouches, perforate the mesodermal layer, reach the ectoderm, and break through to form pharyngeal, or gill, clefts. In fishes and larvae of amphibians, these clefts develop gills and become respiratory organs.

What is the difference between pharyngeal pouches and arches? ›

Arches do not develop simultaneously but instead possess a "staggered" development. Pharyngeal pouches form on the endodermal side between the arches, and pharyngeal grooves (or clefts) form from the lateral ectodermal surface of the neck region to separate the arches.

Can you live with Zenker's diverticulum? ›

Patients who are treated for Zenker's diverticulum have an excellent prognosis, and most patients become free of any swallowing difficulty. A small number of patients (about 20%) continue to experience some difficulty swallowing, but it does not affect their well-being.

How do I get food out of my throat and pockets? ›

Ways to remove food stuck in throat
  1. The 'Coca-Cola' trick. Research suggests that drinking a can of Coke, or another carbonated beverage, can help dislodge food stuck in the esophagus. ...
  2. Simethicone. ...
  3. Water. ...
  4. A moist piece of food. ...
  5. Alka-Seltzer or baking soda. ...
  6. Butter. ...
  7. Wait it out.

Is Zenker's diverticulum rare? ›

Zenker's diverticulum is rare, occurring in less than 0.01% of the population. It's found more often in women than in men, usually those 60 years old or more. This disorder can be associated with hiatal hernias, esophageal spasm, gastroesophageal reflux disease, and, rarely, cancer of the esophagus.

What is dohlman procedure? ›

Endoscopic diverticulotomy (Dohlman's procedure) is a well-established and effective alternative to external diverticulectomy in the treatment of pharyngeal pouch. The division of the common septum between the pouch and the oesophagus is usually performed either with electrocautery or with a laser.

What is pharyngeal pouch syndrome? ›

Pharyngeal pouches occur most commonly in elderly patients (over 70 years) and typical symptoms include dysphagia, regurgitation, chronic cough, aspiration, and weight loss. The aetiology remains unknown but theories centre upon a structural or physiological abnormality of the cricopharyngeus.

What is Killian's dehiscence? ›

The anatomy of the wall has been proposed to be dehiscent in the region of the Killian's triangle, between the thyropharyngeus muscle (inferior pharyngeal constrictor) and the cricopharyngeus muscle. A dehiscence is a bursting open, splitting or gaping along natural or sutured lines.

Is Zenker's diverticulum hereditary? ›

The formation of the pouch does not appear to be hereditary. In many patients who have a Zenker's diverticulum, other problems of the esophagus are present, though not always. What are the most common symptoms of Zenker's diverticulum? The most common symptom of Zenker's diverticulum is difficulty swallowing food.

Can Zenker's diverticulum cause phlegm? ›

Zenker's Diverticulum Symptoms

Difficult and uncomfortable swallowing. Regurgitation of food many hours following a meal. Choking or coughing when attempting to consume solid foods. A feeling of excessive phlegm or mucus in the throat.

What are the signs and symptoms of Zenker's degeneration? ›

What Are the Symptoms of Zenker's Diverticulum?
  • Dysphagia (difficulty swallowing)
  • Regurgitation (return of undigested food back into the mouth)
  • Sense of a lump in the neck.
  • Halitosis (smelly breath) due to stagnant food in the pouch.
  • Cough, especially at night.
  • Hoarseness (voice change)

Does Zenker's diverticulum cause weight loss? ›

Introduction: Zenker's diverticulum is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle. It occurs commonly in elderly patients (over 70 years) and the typical symptoms include dysphagia, regurgitation, chronic cough, aspiration and weight loss.

Can Zenker's diverticulum cause neck pain? ›

Bad breath (halitosis) due to microorganisms digesting stagnant food. Coughing due to regurgitated food in your airway. Lump in the neck feeling. Pain .

How do you repair a Zenker's diverticulum? ›

Zenker's diverticular pouch

Treatment for symptomatic ZD can be surgical or endoscopic. The surgical approach involves an external neck incision with CP myotomy (diverticulotomy), with or without pouch intervention (inversion, diverticulopexy or diverticulectomy).

Why do I feel like I have mucus stuck in my throat all the time? ›

When mucus starts to build up or trickle down the back of the throat, this is known as postnasal drip. Causes of postnasal drip include infections, allergies, and acid reflux. As well as feeling the need to clear the throat frequently, a person with postnasal drip may also experience: a sore throat.

What is the best medicine for dysphagia? ›

Diltiazem: Can aid in esophageal contractions and motility, especially in the disorder known as the nutcracker esophagus. Cystine-depleting therapy with cysteamine: Treatment of choice for patients with dysphagia due to pretransplantation or posttransplantation cystinosis.

Will dysphagia go away? ›

Many cases of dysphagia can be improved with treatment, but a cure isn't always possible. Treatments for dysphagia include: speech and language therapy to learn new swallowing techniques. changing the consistency of food and liquids to make them safer to swallow.

What does Zenker's diverticulum feel like? ›

What are the symptoms of Zenker's diverticulum? Symptoms include difficulty swallowing, feeling swallowed material sticking in the throat, regurgitation, weight loss, bad breath, choking, and coughing. Swallowed material may accumulate in the diverticulum and be regurgitated long after a meal.

Is Zenker a true diverticulum? ›

A Zenker diverticulum is a false diverticulum consisting of mucosa and submucosa that arises from the posterior portion of the inferior pharyngeal constrictor muscle. True diverticula consist of all layers of the wall, whereas false diverticula generally lack the muscularis layer.

Is esophageal diverticulum cancerous? ›

There have been 70 cases of esophageal cancer with a diverticulum reported in the medical literature. The prevalences of cancer in a diverticulum are 0.3–7%, 1.8–4% and 0.3–3% for pharyngoesophageal, tracheal bifurcation and epiphrenic diverticula, respectively.

Can you eat with Zenker's diverticulum? ›

Mild cases of Zenker's diverticulum may require little more than changes to how an individual eats, such as chewing foods well, drinking a lot of water after meals, and eliminating high-fat, spicy and acidic foods from the diet. Cases that are moderate to severe usually require surgery.

Is pharyngeal pouch serious? ›

A pharyngeal pouch is like a hernia at the top of your oesophagus. They usually grow slowly and it can be many years before patients realise they have problems. While some pouches do not cause any problems, some can cause difficulty swallowing, regurgitation of food and lead to chest infections.

Does Zenker's diverticulum cause dysphagia? ›

Zenker's diverticulum (ZD) is an uncommon but highly treatable cause of dysphagia.

What does a ruptured esophagus feel like? ›

Symptoms of Esophageal Ruptures

Symptoms of rupture of the esophagus include chest pain, abdominal pain, vomiting, vomiting blood, low blood pressure, and fever.

Can you have diverticulitis in your throat? ›

Zenker's diverticula (pharyngoesophageal) is the most common type of diverticula of the esophagus. Zenker's diverticula are usually located in the back of the throat, just above the esophagus.

Can diverticulitis cause neuropathy? ›

Diverticular disease is associated with an enteric neuropathy as revealed by morphometric analysis. Neurogastroenterol Motil.

What causes a pouch in your throat? ›

It is believed that the internal pressure produced by the esophagus to move food into the stomach can herniate the esophageal lining through a weakened wall, creating a pouch or a diverticulum.

What is the treatment for esophageal diverticulum? ›

This involves removing a larger diverticulum by turning it upside down and attaching it to the wall of the esophagus. Diverticulectomy and cricopharyngeal myotomy. This involves removing the diverticulum while performing a cricopharyngeal myotomy. It's a combination that's often used to treat Zenker's diverticula.

How is pharyngeal pouch diagnosis? ›

Medical tests to diagnose pharyngeal pouch

To determine if your symptoms are caused by pharyngeal pouch or another condition, your specialist may recommend specific tests such as a diagnostic endoscopy or a barium x-ray test – an x-ray with a white liquid that shows clearly in x-ray scans.

Can Zenker's diverticulum be cured? ›

Zenker's diverticula are normally not treated unless they cause symptoms. Symptomatic diverticula are usually treated by surgery. The surgeon cuts the muscle between the throat and esophagus and removes the pouch.

How do I live with Zenker's diverticulum? ›

Zenker's Diverticulum Treatment Options

For individuals with mild cases, changes to your diet and eating habits, such as drinking water after meals or chewing food thoroughly, may be beneficial. Endoscopic Zenker's diverticulum surgery is recommended for severe cases.

Is Zenker's diverticulum cancerous? ›

Zenker's diverticulum (ZD) has been increasingly recognized as a site of primary epithelial malignancy.

How many pharyngeal pouches are there? ›

There are six pharyngeal pouches in mammals and birds. Humans have four pharyngeal pouches, as the fifth and sixth pharyngeal pouches are comprised within the fourth pharyngeal pouch. Pharyngeal pouch development is hypothetically independent of neural crest migration towards the endoderm.

What kind of doctor does surgery for Zenker's diverticulum? ›

UPMC thoracic surgeons perform both traditional and minimally invasive surgery for treating Zenker's diverticulum. Traditional surgery involves an open neck incision. The minimally invasive technique uses a transoral (through-the-mouth) approach.

Can diverticula pockets go away? ›

Once diverticula form, they do not disappear by themselves. Fortunately, most patients with diverticulosis do not have symptoms, and therefore do not need treatment.

What type of surgeon does Zenker's diverticulum? ›

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 ...

Does pharyngeal pouch cause dysphagia? ›

A pharyngeal pouch is an important cause of dysphagia in older patients that can present with a variety of symptoms (including chest infections, weight loss and halitosis). The gold standard investigation for a pharyngeal pouch is a barium swallow test.

How serious is Zenker's diverticulum? ›

If left untreated, Zenker's diverticulum can increase in size, making your symptoms worse. Over time, severe symptoms such as difficulty swallowing and regurgitation can make it difficult to stay healthy. You might experience malnutrition. Aspiration is a symptom of Zenker's diverticulum.

What is the most common presentation of a patient with a Zenker diverticulum? ›

Patients with Zenker diverticulum will typically present with a long history of dysphagia followed by a sensation of food stuck in the throat. Up to 98% of patients have the primary complaints of dysphagia. Other common symptoms include recurrent coughing, fetor ex ore (halitosis), and unexplained weight loss.

How do I get food out of my throat and pockets? ›

Ways to remove food stuck in throat
  1. The 'Coca-Cola' trick. Research suggests that drinking a can of Coke, or another carbonated beverage, can help dislodge food stuck in the esophagus. ...
  2. Simethicone. ...
  3. Water. ...
  4. A moist piece of food. ...
  5. Alka-Seltzer or baking soda. ...
  6. Butter. ...
  7. Wait it out.

Is Zenker diverticulum precancerous? ›

Abstract. Background: Pharyngeal diverticulum or Zenker's diverticulum carcinoma is a rare malignancy with a poor prognosis. Carcinoma arising in a recurrent pharyngeal diverticulum is even rarer, with only 1 such case reported in the English-language literature.

Is Zenker's diverticulum rare? ›

Zenker's diverticulum is rare, occurring in less than 0.01% of the population. It's found more often in women than in men, usually those 60 years old or more. This disorder can be associated with hiatal hernias, esophageal spasm, gastroesophageal reflux disease, and, rarely, cancer of the esophagus.

Videos

1. Endoscopic Pouch Stapling
(ENTLondon)
2. Pharyngeal pouches - What are they? | Martin Birchall
(Top Doctors UK)
3. I have a pharyngeal pouch, what does that mean?
(Top Doctors UK)
4. Trans-Oral Laser for the Treatment of Zenker’s Diverticulum | Dr. Babak Larian in Los Angeles
(LarianMD)
5. WHAT IS ZENKER'S DIVERTICULUM? | PHARYNGEAL POUCH | MBBS | SURGERY| How to manage pharyngeal pouch?
(Dr. Pushpa NEET PG Galaxy)
6. pouch with title NTSC DV 24p
(Gerard Kelly)
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