Pharyngeal (Zenker's) diverticulum is a disorder of upper esophageal sphincter opening
Open accessAbstract
Pharyngeal coordination, sphincter opening, and flow pressures during swallowing were investigated in patients with pharyngeal (Zenker's) diverticula. Fourteen patients with diverticula and 9 healthy age-matched controls were studied using simultaneous videoradiography and manometry. Pharyngeal and upper esophageal sphincter pressures were recorded by a perfused side hole/sleeve assembly. Temporal relationships among swallowing events, extent of sphincter opening during swallowing, and intrabolus pressure during bolus passage across the sphincter were measured. The timing among pharyngeal contraction and sphincter relaxation, opening, and closure did not differ between patients and controls. Sphincter opening was significantly reduced in patients compared with controls in sagittal (P = 0.0003) and transverse (P = 0.005) planes. Manometric sphincter relaxation was normal in patients. Intrabolus pressure was significantly greater in patients than in controls (P = 0.001). It is concluded that Zenker's diverticulum is a disorder of diminished upper esophageal sphincter opening that is not caused by pharyngosphincteric incoordination or failed sphincter relaxation. Incomplete sphincter opening is likely to cause dysphagia. Increased hypopharyngeal pressures during swallowing are probably important in the pathogenesis of the diverticulum.
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Abnormalities in PES opening are well-suited to examination with manometry.
“Abnormalities in PES opening are well-suited to examination with manometry19,20 and normal opening is easily identified on the HRM spatiotemporal plot as a decrease in pressure at the UES to or below atmospheric pressure.”
From Classification of high-resolution manometry data according to videofluoroscopic parameters using pattern recognition (2013) · cites this paper as [19]
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- Authors
- Cook, I. J., Gabb, M., Panagopoulos, V., Jamieson, G. G., Dodds, W. J., Dent, J., & Shearman, D. J.
- Affiliations
- Froedtert Hospital (US)
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 1992-10
- Volume
- 103
- Issue
- 4
- Pages
- 1229-1235
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W1885846526
- Cited by
- 342
- References
- 21
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 8 · 2023: 7 · 2022: 15 · 2021: 21 · 2020: 9 · 2019: 11 · 2018: 10 · 2017: 11 · 2016: 8 · 2015: 13 · 2014: 5 · 2013: 14 · 2012: 17
- FWCI
- 32.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01dc000669-09)
- National Institute on Deafness and Other Communication Disorders (R01-DC00669)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK-25731, R01DK025731)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Surgery › Esophageal and GI Pathology
- Keywords
- Zenker's diverticulum, pharyngeal diverticulum, upper esophageal sphincter, swallowing, intrabolus pressure, dysphagia, esophageal manometry
- MeSH terms
- Aged, Aged, 80 and over, Esophagogastric Junction, Female, Humans, Male, Middle Aged, Muscle Relaxation, Pressure, Zenker Diverticulum
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