Short-term quality-of-life outcomes following transoral diverticulotomy for Zenker's diverticulum

Kathryn M. Van Abel, Nicole M. Tombers, Kari A. Krein, Eric J. Moore, Daniel L. Price, Jan L. Kasperbauer, Michael L. Hinni, David G. Lott, Dale C. Ekbom

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Objective To prospectively analyze quality-of-life outcomes following transoral diverticulotomy with cricopharyngeal myotomy (DCPM) for Zenker's diverticulum (ZD). Study Design Prospective single-group study. Settings Tertiary academic institution. Subjects and Methods A prospective multicenter study performed from January 1, 2012, to July 1, 2014, included 18 patients presenting with ZD undergoing DCPM. Standardized questionnaires - including the 10-item Eating Assessment Tool (EAT-10), Functional Outcome of Swallowing Scale (FOSS), and the Reflux Symptom Index (RSI) - were completed preoperatively and at 3 and 6 months postoperatively. Videofluoroscopic studies were obtained and analyzed by our senior speech-language pathologist, who was blinded to the clinical outcomes. Results Eighteen patients were included (11 women; mean age, 72.6 years; range, 53-86 years). All patients had ZD on preoperative videofluoroscopic swallowing studies. The most common comorbidities included hypertension (10 of 18, 55.6%), dyslipidemia (8 of 18, 44.4%), hiatal hernia (6 of 18, 33.3%), and gastroesophageal reflux disease (5 of 18, 27.8%). Median preoperative RSI was 27 (interquartile range [IQR], 22.5-31.5); FOSS, 2 (IQR, 2-3); and EAT-10, 21.5 (IQR, 13.5-27.5). The 3-month questionnaire (88.9% completion) demonstrated an improved median RSI of 5 (IQR, 1-7.5; P <.001), FOSS of 0 (IQR, 0; P <.001), and EAT-10 of 0 (IQR, 0-3; P <.001). Fourteen patients (77.8%) completed the 6-month questionnaire, demonstrating a median RSI of 4 (IQR, 0-8), FOSS of 0 (IQR, 0-0.5), and EAT-10 of 1 (IQR, 0-3). While regurgitation decreased following surgery (P =.007), nighttime cough did not (P =.25). Conclusion This study supports an improvement in functional outcome and quality of life in patients with ZD undergoing DCPM.

Original languageEnglish (US)
Pages (from-to)322-327
Number of pages6
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume154
Issue number2
DOIs
StatePublished - Feb 1 2016

Keywords

  • EAT-10
  • FOSS
  • RSI
  • Zenker's diverticulum
  • cricopharyngeal bar
  • cricopharyngeal dysfunction
  • cricopharyngeal myotomy
  • functional outcome swallowing scale
  • quality of life
  • reflux symptom index
  • regurgitation

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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