Cricopharyngeal spasm and Zenker's diverticulum

Area of Science:

• Gastroenterology and Otolaryngology
• Disorders of the pharyngoesophageal junction

Background:

• Cricopharyngeal spasm and Zenker's diverticulum are common conditions affecting the pharyngoesophageal junction.
• The exact cause remains unclear, but gastroesophageal reflux is a suspected contributing factor.

Purpose of the Study:

• To review the current understanding of the etiology of cricopharyngeal spasm and Zenker's diverticulum.
• To discuss the role of gastroesophageal reflux in these conditions.
• To highlight management strategies, focusing on cricopharyngeal myotomy and endoscopic techniques.

Main Methods:

• Literature review of studies investigating the etiology and management of cricopharyngeal spasm and Zenker's diverticulum.
• Analysis of evidence supporting the association with gastroesophageal reflux.
• Comparison of outcomes between traditional open surgery and newer transoral endoscopic techniques.

Main Results:

• Evidence suggests a significant association between gastroesophageal reflux and both cricopharyngeal spasm and Zenker's diverticulum.
• Cricopharyngeal myotomy is identified as the primary treatment for both conditions.
• Transoral endoscopic techniques demonstrate lower morbidity compared to open surgery in selected patients.

Conclusions:

• Gastroesophageal reflux is a relevant factor in the pathophysiology of cricopharyngeal spasm and Zenker's diverticulum.
• Cricopharyngeal myotomy is the cornerstone of effective management.
• Minimally invasive endoscopic approaches are increasingly preferred due to improved patient outcomes and reduced complications.