{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T07:33:40Z","timestamp":1778139220761,"version":"3.51.4"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003Zenker diverticulum (ZD) usually affects adults after the 7th decade of life. Treatment for ZD is indicated for all symptomatic patients, but some patients prefer to defer surgical treatment until symptoms get worse and decrease their quality of life.<\/jats:p><jats:p>\n          Objective\u2003To evaluate the association of the preoperative symptoms in ZD patients with the size of the ZD.<\/jats:p><jats:p>\n          Methods\u2003A retrospective study design. Electronic medical records were used to identify patients diagnosed with ZD and treated over 11 years. Data collection included the chief complaints and symptoms, medical history, and findings on radiologic swallow evaluations of the patients. The diverticulum size was stratified into 3 groups: small (&lt; 1\u2009cm), moderate (1\u20133\u2009cm), and large (&gt; 3\u2009cm).<\/jats:p><jats:p>\n          Results\u2003A total of 165 patients were enrolled and stratified by diverticulum size (48 small, 67 medium, and 50 large). Dysphagia, cough, and regurgitation were the most prevalent symptoms. Dysphonia was more frequent among patients with a small pouch. Logistic regression analysis showed that dysphagia and choking were associated with large and medium diverticulum size (p\u2009&lt;\u20090.05). Additionally, dysphonia was significantly associated with the presence of a small-sized ZD (p\u2009&lt;\u20090.04).<\/jats:p><jats:p>\n          Conclusion\u2003Upper gastrointestinal symptoms such as dysphagia and choking may be associated with a ZD\u2009&gt;\u20091\u2009cm and should always be evaluated. Additionally, the presence of dysphonia was found to be correlated with a ZD\u2009&lt;\u20091\u2009cm, suggesting that a prompt and appropriate fluoroscopic evaluation must be considered in those patients in whom no other clear cause of dysphonia is evident.<\/jats:p>","DOI":"10.1055\/s-0041-1730457","type":"journal-article","created":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:59:26Z","timestamp":1635296366000},"page":"e334-e338","source":"Crossref","is-referenced-by-count":7,"title":["Zenker Diverticulum: Does Size Correlate with Preoperative Symptoms?"],"prefix":"10.1055","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9421-1287","authenticated-orcid":false,"given":"Jhon F.","family":"Martinez-Paredes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9781-8006","authenticated-orcid":false,"given":"Razan","family":"Alfakir","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2345-1157","authenticated-orcid":false,"given":"Jan L.","family":"Kasperbauer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7704-6328","authenticated-orcid":false,"given":"Amy","family":"Rutt","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,10,26]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1111\/j.1440-1746.1992.tb01485.x","article-title":"Structural abnormalities of the cricopharyngeus muscle in patients with pharyngeal (Zenker's) diverticulum","volume":"7","author":"I J Cook","year":"1992","journal-title":"J Gastroenterol Hepatol"},{"issue":"09","key":"ref3","doi-asserted-by":"crossref","first-page":"2755","DOI":"10.1007\/s00405-015-3825-0","article-title":"Zenker's diverticulum: Rotterdam experience","volume":"273","author":"L J Visser","year":"2016","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"07","key":"ref4","first-page":"546","article-title":"[Extraesophageal reflux in patients suffering from Zenker's diverticulum]","volume":"55","author":"C Morales-Divo","year":"2007","journal-title":"HNO"},{"issue":"910","key":"ref5","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1136\/pmj.77.910.506","article-title":"Pharyngeal pouch (Zenker's diverticulum)","volume":"77","author":"M A Siddiq","year":"2001","journal-title":"Postgrad Med J"},{"issue":"05","key":"ref6","first-page":"284","article-title":"Zenker's diverticulum: aetiopathogenesis, symptoms and diagnosis. Comparison of operative methods","volume":"8","author":"P Nehring","year":"2013","journal-title":"Prz Gastroenterol"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1177\/000348949410300303","article-title":"Meditation on the pathogenesis of hypopharyngeal (Zenker's) diverticulum and a report of endoscopic treatment in 545 patients","volume":"103","author":"J J van Overbeek","year":"1994","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1442-2050.2007.00795.x","article-title":"Zenker's diverticula: pathophysiology, clinical presentation, and flexible endoscopic management","volume":"21","author":"L E Ferreira","year":"2008","journal-title":"Dis Esophagus"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1177\/0194599812465726","article-title":"Dysphagia characteristics in Zenker's diverticulum","volume":"148","author":"J L Bergeron","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1097\/MLG.0b013e3180305061","article-title":"Dysphagia after endoscopic repair of Zenker's diverticulum","volume":"117","author":"A D Palmer","year":"2007","journal-title":"Laryngoscope"},{"issue":"11","key":"ref11","doi-asserted-by":"crossref","first-page":"2475","DOI":"10.1002\/lary.25975","article-title":"Does residual wall size or technique matter in the treatment of Zenker's diverticulum?","volume":"126","author":"R N Shah","year":"2016","journal-title":"Laryngoscope"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/j.athoracsur.2015.04.029","article-title":"Long-Term Outcome of the Treatment of Zenker's Diverticulum","volume":"100","author":"C L Greene","year":"2015","journal-title":"Ann Thorac Surg"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1177\/000348949910800314","article-title":"The \u201csign of the rising tide\u201d during swallowing fiberoscopy: a specific manifestation of Zenker's diverticulum","volume":"108","author":"S P\u00e9ri\u00e9","year":"1999","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"02","key":"ref14","first-page":"80","article-title":"The association of gastroesophageal reflux and otolaryngologic disorders","volume":"21","author":"D N Cote","year":"1995","journal-title":"Compr Ther"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1007\/s00405-005-1036-9","article-title":"Pharyngeal pouch: associations and complications","volume":"263","author":"P Sen","year":"2006","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"S 02","key":"ref16","doi-asserted-by":"crossref","first-page":"S154","DOI":"10.21037\/jtd.2017.03.133","article-title":"Zenker's diverticulum: flexible versus rigid repair","volume":"9","author":"K Beard","year":"2017","journal-title":"J Thorac Dis"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1007\/s00455-017-9813-3","article-title":"Voice Outcomes in Surgical Repair of Zenker's Diverticulum","volume":"32","author":"S Schoeff","year":"2017","journal-title":"Dysphagia"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3949\/ccjm.76a.08032","article-title":"Role of barium esophagography in evaluating dysphagia","volume":"76","author":"B C Allen","year":"2009","journal-title":"Cleve Clin J Med"}],"container-title":["International Archives of Otorhinolaryngology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1730457.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T00:08:48Z","timestamp":1657843728000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1730457"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,26]]},"references-count":17,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2022,7,14]]},"published-print":{"date-parts":[[2022,7]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1730457","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1809-9777","1809-4864"],"issn-type":[{"value":"1809-9777","type":"print"},{"value":"1809-4864","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,26]]}}}