›› 2011, Vol. 31 ›› Issue (6): 821-.doi: 10.3969/j.issn.1674-8115.2011.06.031

• Original article (Clinical research) • Previous Articles     Next Articles

Role of videoendoscopic swallowing study in evaluation of surgical outcome of Zenker's diverticulum

CHEN Jia-rui1, Jean Lacau Saint Guily2, WANG Jia-dong1   

  1. 1.Department of Otolaryngology-Head &|Neck Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Otolaryngology Institute of Shanghai Jiaotong University, Shanghai 200001, China;2.Service d'ORL et Chirurgie Cervico-Faciale, Université|Pierre et Marie Curie, Paris 6, Hopital Tenon l'Assistance PubliqueHopitaux de Paris, Paris 75020, France
  • Online:2011-06-28 Published:2011-06-27


Objective To investigate the role of rising tide sign (RTS) in videoendoscopic swallowing study (VESS) in the diagnosis and evaluation of surgical outcome of Zenker's diverticulum. Methods The clinical data of 148 patients with Zenker's diverticulum undergoing operations consecutively between May 1998 and April 2010 were retrospectively analysed. VESS was performed preoperatively and postoperatively, and the results were compared for the presence of RTS. Videoendoscopic characteristics based on the times of swallow before onset of RTS and the preoperative size of Zenker's diverticulum on barium swallow were also compared with a randomly selected subset of 38 patients with Zenker's diverticulum. Finally, the videoendoscoic recordings of 25 patients with isolated upper esophageal sphincter dysfunction without Zenker's diverticulum were retrospectively reviewed to look for RTS. Results All these 148 patients presented RTS on the preoperative VESS. No correlation was observed between the times of swallow before onset of RTS and the size of diverticulum (P>0.05). Follow-up data were available for 121 patients, and 111 patients were significantly improved in symptoms with complete disappearance of RTS. Recurrence of symptoms was observed during follow-up in 10 patients, 7 of whom had recurrence of RTS after a mean follow-up of 37 months. In contrast, RTS was never observed in the 25 patients with isolated upper esophageal sphincter dysfunction. Conclusion RTS observed in VESS is a specific feature of Zenker's diverticulum. VESS can be used as a supplementary tool for the diagnosis of Zenker's diverticulum and evaluation of surgical outcome during follow-up.

Key words: Zenker´s diverticulum, rising tide sign, videoendoscopy swallowing study