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Unintentional Weight Loss Does Not Predict Poor Outcomes in Zenker Diverticulum
Ari D Schuman1, Jacqui Allen2, Mekibib Altaye3
1Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio, USA.
The Laryngoscope
|July 18, 2026
Summary
Unintentional weight loss is common in Zenker diverticulum (ZD) patients, correlating with dysphagia severity but not symptom duration or diverticulum size. Surgery offers similar safety and improved swallowing for those experiencing weight loss.
Area of Science:
- Gastroenterology
- Otolaryngology
- Surgical Research
Background:
- Zenker diverticulum (ZD) is often associated with unintentional weight loss.
- Cricopharyngeal muscle dysfunction (CPMD) is a key factor in ZD pathophysiology.
- The relationship between weight loss, symptom duration, and diverticulum size in CPMD requires further investigation.
Purpose of the Study:
- To investigate the association between unintentional weight loss (+WL) and factors like symptom duration and diverticulum size in patients with CPMD.
- To compare patient-reported outcomes (EAT-10 scores) and postoperative complications between patients with and without weight loss.
Main Methods:
- A prospective, multicenter observational study enrolled 427 patients with CPMD.
- Patients were categorized into +WL and no weight loss (-WL) groups.
- Data collected included demographics, weight loss, symptom duration, diverticulum size, and EAT-10 scores.
Main Results:
- 101 patients (23.6%) experienced unintentional weight loss, with a median loss of 14 pounds.
- +WL patients had higher preoperative EAT-10 scores, indicating worse dysphagia (p < 0.0001).
- Weight loss was associated with diverticulum size (p=0.003) and CP bars, but not symptom duration (p=0.30).
Conclusions:
- Unintentional weight loss is a significant indicator of dysphagia severity in ZD patients.
- Weight loss in ZD is linked to dysphagia and diverticulum characteristics, not solely symptom duration.
- Surgical intervention demonstrates a similar safety profile and greater dysphagia improvement in patients with preoperative weight loss.
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