{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T15:06:22Z","timestamp":1788620782253,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010836","name":"American Laryngological, Rhinological and Otological Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010836","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify characteristics of patients who have poor improvement in symptoms following surgical management of Zenker Diverticulum (ZD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective, multicenter cohort study of all individuals enrolled in the Prospective OUtcomes of Cricopharyngeus Hypertonicity (POUCH) Collaborative who underwent surgical repair of ZD between August 2017 and January 2024. Patient demographics, esophagrams, and the 10\u2010item Eating Assessment Tool (EAT\u201010) pre\u2010 and post\u2010procedure were obtained from a REDCap database. <jats:italic>t<\/jats:italic>\u2010tests, Wilcoxon rank sum tests, Chi\u2010square or Fisher's exact tests were used to compare the characteristics. Patients with &lt;50% improvement in their EAT\u201010 scores were deemed surgical nonresponders (SNRs). Those with \u226550% improvement in their EAT\u201010 scores were deemed surgical responders (SRs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 184 patients were prospectively followed after undergoing either open or endoscopic surgical management. Twenty\u2010two patients (12%) were deemed SNRs. Preoperative presence of a hiatal hernia was statistically significant characteristic between the SNRs (63.6%) and SRs (32.1%) (<jats:italic>p<\/jats:italic>\u2009=\u20090.004). Size of the ZD and history of previous ZD surgery was not a significant characteristic. The length of stay and complication rate were not statistically different between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Coexistent esophageal pathology may lead to poor symptomatic improvement following ZD surgery. Preoperative workup of other esophageal disorders is recommended to detect likely SNRs. For SNRs, further esophageal workup may be necessary to evaluate for other esophageal causes related to poor symptomatic improvement following ZD surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 134:4897\u20134902, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31619","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T10:38:56Z","timestamp":1720521536000},"page":"4897-4902","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Surgical Nonresponders in Zenker Diverticulum and Lower Esophageal Pathology (<scp>POUCH<\/scp> Collaborative)"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2880-338X","authenticated-orcid":false,"given":"Johnathan","family":"Brown","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery 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Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Dion","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8770-8463","authenticated-orcid":false,"given":"Dale","family":"Ekbom","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati College of Medicine  Cincinnati Ohio 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