Citations 2
Killian Jamieson Diverticulum, the Great Mimicker: A Case Series and Contemporary Review
Howell, Rebecca J. , Tang, Alice L. , Allen, Jacqui , Altaye, Mekibib , Bayan, Semirra L. , Belafsky, Peter C. , Cervenka, Brian , deSilva, Brad W. , Dion, Gregory R. , Ekbom, Dale C. , Friedman, Aaron D. , Fritz, Mark A. , Giliberto, John Paul , Harmon, Jeffrey , Kasperbauer, Jan L. , Khosla, Sid , Kim, Brandon , Kuhn, Maggie A. , Madden, Lyndsay L. , Matrka, Laura , Mayerhoff, Ross , Piraka, Cyrus , Rosen, Clark A. , Wahab, Shaun A. , Wilson, Keith , Wright, Stephen C. , Young, VyVy N. , Yuen, Sonia , Postma, Gregory N. , Howell, Rebecca , Bayan, Semirra, Belafsky, Peter , deSilva, Brad , Dion, Greg , Ekbom, Dale , Giliberto, John Paul , Kasperbauer, Jan , Kuhn, Maggie , Matrka, Laura , Mayerhoff, Ross , Rosen, Clark , Tabangin, Meredith , Young, Vyvy , Yuen, Sonia , Bayan, Semirra , Amin, Milan R , Guardiani, Elizabeth , Kwak, Paul E. , Ma, Yue , Tabangin, Meredith E. , Wilson, Keith, Wright, S. Carter
The Laryngoscope | December 1, 2022 | Volume: 133 | Issue: 9 | Pages: 2110-2115
ObjectiveTo assess barium esophagram (BAS) as a diagnostic marker for patients with Killian Jamieson diverticula (KJD).MethodsProspective, multicenter cohort study of individuals enrolled in the Prospective OUtcomes of Cricopharyngeus Hypertonicity (POUCH) Collaborative. Patient demographics, comorbidities, radiographic imaging reports, laryngoscopy findings, patient‐reported outcome measures (PROM), and operative reporting were abstracted from a REDCap database and summarized using means, medians, percentages, frequencies. Paired t‐tests and Wilcoxon Signed Rank test were used to test pre‐ to post‐operative differences in RSI, EAT‐10, and VHI‐10 scores. Diagnostic test evaluation including sensitivity, specificity, positive, and negative predictive value with 95% confidence intervals were calculated comparing BAS findings to operative report.ResultsA total of 287 persons were enrolled; 13 (4%) patients were identified with confirmed KJD on operative reports. 100% underwent open transcervical excision. BAS has a 46.2% (95% confidence interval [CI]: 23.2, 70.9) sensitivity and 97.8% (95% CI: 95.3, 99.0) specificity in detecting a KJD and 50% (95% CI: 25.4, 74.6) positive predictive value but 97.4% (95%CI: 94.8, 98.7) negative predictive value. Preoperatively, patients reported mean (SD) RSI and EAT‐10 of 19.4 (9) and 8.3 (7.5) accordingly. Postoperatively, patients reported mean (SD) RSI and EAT‐10 as 5.4 (6.2) and 2.3 (3.3). Both changes in RSI and EAT‐10 were statistically significant (p = 0.008, p = 0.03).ConclusionKJD are rare and represent <5% of hypopharyngeal diverticula undergoing surgical intervention. Open transcervical surgery significantly improves symptoms of dysphagia. BAS has high specificity but low sensitivity in detecting KJD.Level of Evidence4 Laryngoscope, 133:2110–2115, 2023
Cricopharyngeus Muscle Dysfunction and Hypopharyngeal Diverticula (e.g., Zenker): A Multicenter Study
Howell, Rebecca J. , Ekbom, Dale C. , Kasperbauer, Jan L. , Tabangin, Meredith E. , Altaye, Mekibib , Wahab, Shaun A. , Belafsky, Peter C. , Allen, Jacqui , Bayan, Semirra L. , Cervenka, Brian , deSilva, Brad W. , Friedman, Aaron D. , Fritz, Mark A. , Giliberto, John Paul , Harmon, Jeffrey , Khosla, Sid , Kim, Brandon , Kuhn, Maggie A. , Madden, Lyndsay L. , Matrka, Laura , Piraka, Cyrus , Rosen, Clark A. , Wilson, Keith , Wright, Carter , Young, VyVy N. , Yuen, Sonia , Postma, Greg, Ekbom, Dale , Kasperbauer, Jan , Tabangin, Meredith , Belafsky, Peter , Bayan, Semirra, Giliberto, John Paul , Bayan, Semirra , Dion, Gregory R. , Guardiani, Elizabeth , Kwak, Paul E. , Ma, Yue , Mayerhoff, Ross , Wilson, Keith, Wright, Carter
The Laryngoscope | September 14, 2022 | Volume: 133 | Issue: 6 | Pages: 1349-1355
ObjectiveTo describe demographics and imaging and compare findings and symptoms at presentation in a large cohort of persons with cricopharyngeus muscle dysfunction (CPMD) with and without hypopharyngeal diverticula.MethodologyProspective, multicenter cohort study of all individuals enrolled in the Prospective OUtcomes of Cricopharyngeal Hypertonicity (POUCH) Collaborative. Patient survey, comorbidities, radiography, laryngoscopy findings, and patient‐reported outcome measures (e.g., Eating Assessment Tool [EAT‐10]) data were abstracted from a REDCap database and summarized using means, medians, percentages, and frequencies. Diagnostic categories were compared using analysis of variance.ResultsA total of 250 persons were included. The mean age (standard deviation [SD]) of the cohort was 69.0 (11.2). Forty‐two percent identified as female. Zenker diverticula (ZD) was diagnosed in 85.2%, 9.2% with CPMD without diverticula, 4.4% with a Killian Jamieson diverticula (KJD), and 1.2% traction‐type diverticula. There were no differences between diagnostic categories in regard to age, gender, and duration of symptoms (p = 0.25, 0.19, 0.45). The mean (SD) EAT‐10 score for each group was 17.1 (10.1) for ZD, 20.2 (9.3) for CPMD, and 10.3 (9.4) for KJD. Patients with isolated CPMD had significantly greater EAT‐10 scores compared to the other diagnostic groups (p = 0.03).ConclusionZD is the most common, followed by CPMD without diverticula, KJD, and traction‐type. Patients with isolated obstructing CPMD may be more symptomatic than persons with ZD or KJD.Level of Evidence4 Laryngoscope, 133:1349–1355, 2023