{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T05:16:02Z","timestamp":1788585362028,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To define persistent and recurrent dysphagia after surgery for CPMD with and without diverticula.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with CPMD with and without diverticula enrolled in the Prospective Outcomes of Cricopharyngeus Hypertonicity (POuCH) multicenter study who underwent surgery from November 2014 to August 2024 with at least 12\u2009months of follow up were included. Surgical outcomes were evaluated using a validated patient reported dysphagia marker, Eating Assessment Tool 10 (EAT10), where normal is characterized as &lt;\u20093. Persistent dysphagia is defined as patients with &lt;\u200950% improvement in EAT\u201010\n                      <jats:italic>or<\/jats:italic>\n                      EAT\u201010 score \u2265\u20093 at first follow up. Recurrent dysphagia is an initial surgical responder with a delayed worsening in EAT\u201010 scores during follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 160 patients were included. Six patients (3.7%) had recurrent dysphagia, with 5 undergoing re\u2010operation. A total of 23 patients (14.3%) had persistent dysphagia immediately post\u2010operatively; one underwent re\u2010operation. Preoperative EAT\u201010 scores were higher in the persistent group (median 23.5, interquartile interval (IQR) 12.0\u201328.5) compared to responders (14.0, 8\u201324) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05). Median first post\u2010operative EAT\u201010 in the persistent dysphagia group was 14 (IQR 8\u201321) compared to 0 in the responders (0\u20132;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). There was no difference in esophageal pathology. There was no difference in rates of response to endoscopic versus open surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with recurrent dysphagia are less common than persistent dysphagia, and there are no clear markers to predict surgical responders from persistent dysphagia (e.g., non\u2010responders), however all non\u2010responders occurred in the first 12\u2009months after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>4<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70834","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T04:33:28Z","timestamp":1788582808000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Differentiating Persistent and Recurrent Dysphagia in Zenker Diverticulum: A\n                    <scp>POuCH<\/scp>\n                    Study"],"prefix":"10.1002","author":[{"given":"Ari D.","family":"Schuman","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3302-7045","authenticated-orcid":false,"given":"Jacqui","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mekibib","family":"Altaye","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6992-3212","authenticated-orcid":false,"given":"Milan R.","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery New York University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Semirra L.","family":"Bayan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Cinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Belafsky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California Davis  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0842-9744","authenticated-orcid":false,"given":"Brad W.","family":"DeSilva","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery The Ohio State University Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9873-8641","authenticated-orcid":false,"given":"Shumon","family":"Dhar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Texas Southwestern  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8770-8463","authenticated-orcid":false,"given":"Dale C.","family":"Ekbom","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Cinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron D.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6008-1533","authenticated-orcid":false,"given":"Mark","family":"Fritz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glendon M.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8706-3909","authenticated-orcid":false,"given":"John Paul","family":"Gilberto","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Guardiani","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Maryland  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Medical College of Georgia  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2345-1157","authenticated-orcid":false,"given":"Jan","family":"Kasperbauer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Cinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery The Ohio State University Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0469-9181","authenticated-orcid":false,"given":"Brittany N.","family":"Krekeler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7222-4175","authenticated-orcid":false,"given":"Maggie","family":"Kuhn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California Davis  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1758-3276","authenticated-orcid":false,"given":"Yue","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyndsay L.","family":"Madden","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Wake Forest University  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9558-5202","authenticated-orcid":false,"given":"Laura","family":"Matrka","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery The Ohio State University Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3262-4737","authenticated-orcid":false,"given":"Ross M.","family":"Mayerhoff","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrus","family":"Piraka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology\/Hepatology Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apoorva","family":"Ramaswamy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery The Ohio State University Medical Center  Columbus Ohio 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Mike","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery UT Health San Antonio  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3095-8290","authenticated-orcid":false,"given":"Vyvy N.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Postma","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Medical College of Georgia  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5503-0325","authenticated-orcid":false,"given":"Rebecca J.","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016\u20105085(92)91508\u20102"},{"issue":"6","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/j.otc.2013.08.006","article-title":"Management of Cricopharyngeus Muscle Dysfunction","volume":"46","author":"Kuhn M.","year":"2013","journal-title":"Otolaryngologic Clinics of North America"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.77.910.506"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(16)30120\u20107"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941112001205"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30387"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30753"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815616078"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010013\u20102470\u20108"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489414542421"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i4.1167"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v13.i18.2586"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21413"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.70052"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940811701210"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.04.029"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.23602"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2018.4504"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010021\u201010029\u20107"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2025.108759"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31619"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70834","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70834","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70834","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T04:33:34Z","timestamp":1788582814000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70834"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":21,"alternative-id":["10.1002\/lary.70834"],"URL":"https:\/\/doi.org\/10.1002\/lary.70834","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]},"assertion":[{"value":"2026-01-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"lary.70834"}}