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Cricopharyngeus Muscle Dysfunction and Hypopharyngeal Diverticula (e.g., Zenker): A Multicenter Study
Rebecca J Howell1, Dale Ekbom2, Jan Kasperbauer2
1Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, U.S.A.
The Laryngoscope
|September 14, 2022
Summary
Cricopharyngeus muscle dysfunction (CPMD) with hypopharyngeal diverticula, particularly Zenker diverticula (ZD), is common. Isolated CPMD may cause more severe symptoms than ZD or Killian Jamieson diverticula (KJD).
Area of Science:
- Otolaryngology
- Gastroenterology
- Digestive System Diseases
Background:
- Cricopharyngeus muscle dysfunction (CPMD) is a condition affecting the upper esophageal sphincter.
- Hypopharyngeal diverticula, such as Zenker diverticula (ZD) and Killian Jamieson diverticula (KJD), are associated with CPMD.
- Understanding the prevalence and symptomatic differences between these conditions is crucial for diagnosis and management.
Purpose of the Study:
- To describe the demographics and imaging characteristics of patients with CPMD.
- To compare the clinical findings and symptoms in patients with CPMD, with and without hypopharyngeal diverticula.
- To evaluate patient-reported outcomes, such as dysphagia, in different diagnostic categories.
Main Methods:
- A prospective, multicenter cohort study (Prospective OUtcomes of Cricopharyngeal Hypertonicity Collaborative) was conducted.
- Data on patient demographics, comorbidities, imaging, laryngoscopy, and patient-reported outcomes (EAT-10) were collected.
- Statistical analysis, including analysis of variance, was used to compare diagnostic groups.
Main Results:
- Zenker diverticula (ZD) were diagnosed in 85.2% of 250 participants, followed by CPMD without diverticula (9.2%), Killian Jamieson diverticula (KJD) (4.4%), and traction-type diverticula (1.2%).
- No significant differences in age, gender, or symptom duration were found between diagnostic categories.
- Patients with isolated CPMD reported significantly higher dysphagia symptom scores (EAT-10) compared to those with ZD or KJD.
Conclusions:
- Zenker diverticula (ZD) are the most prevalent condition, followed by CPMD without diverticula, KJD, and traction-type diverticula.
- Patients experiencing isolated, obstructing CPMD may present with more pronounced symptoms than individuals with ZD or KJD.
- This highlights the importance of considering isolated CPMD as a significant cause of dysphagia.
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