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Suffolk Center for Speech

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What is Zenker’s Diverticulum?

  • A diverticulum is a side pocket that forms when pharyngeal or esophageal muscle herniates.
  • On X-ray, the diverticulum appears as a round balloon that fills with radiopaque material as the patient swallows. After the swallow, the diverticulum usually empties of material (Logemann, 1998)

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Prevalence

  • Ranging between 0.01 to 0.11% (U.S.)
  • 1-2 per 100,000 patients/year.
  • Twice as common in males.
  • Typically occurs in middle-aged and elderly patients

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Symptoms

  • 80 – 90% of patients complain of dysphagia
  • Regurgitation of undigested foods
  • Halitosis (bad breath)
  • Hoarseness
  • Reflux
  • 30-40% of patients describe chronic cough and repeated episodes of aspiration, some with aspiration pneumonia
    (Ferreira, Simmons, & Baron, 2007)

Generally treatment for esophageal disorders is surgical or medical.

Sno. External Endoscopic
1. Making an incision on the neck

  • Cricopharyngeal myotomy
  • Diverticulectomy
  • Inversion
  • Diverticulopexy (suspension)
Done through the mouth
2. Longer Procedure The mucosa or muscle that make up the third party wall are divided with an electrocautery laser or an automatic stapler.

  • Dohlman’s (electrocoagulation)
  • Dohlman’s (laser)
  • Stapling
3. Longer Hospital Stay (5-7 days) Shorter Procedure
4. NG feeds (5 days) Shorter Hospital Stay (1-2 days)
5. Oral intake within 24 hours

(Siddiq, Sood, & Strachan, 2001)

SLP Treatment

  • Compensatory Treatment Procedures
    • Control the flow of food and eliminate the patient’s symptoms (aspiration)
      • Postural Techniques
      • Modifying volume and speed of food presentation
      • Food Consistency (Diet) Changes
  • Follow Aspiration Precautions
  • Good Oral Hygiene

(Asofsky, 2017)

Pre-Counseling

  • During preoperative counseling the speech pathologist will address aspects of care.
  • These include strategies for:
    • Effective symptom management
    • Safety issues
    • Nutritional and speech therapy support
    • Coping strategies (Cady, 2002).
  • Explain what the surgery is and possible dietary changes – NG tube or soft consistency diet
  • Counsel the patient and answer their questions or concerns.

– Angie

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