Arquivo da tag: Zenker’s Diverticulum

Swallowing Disorders in the Elderly

Joshua S. Schindler, James H. Kelly

Article first published online: 2 JAN 2009

DOI: 10.1097/00005537-200204000-0000

The Laryngoscope, Volume 112, Issue 4, pages 589–602, April 2002

Abstract

Changes that occur as a natural part of senescence in the complex action of deglutition predispose us to dysphagia and aspiration. As the “baby-boomers” begin to age, the onset of swallowing difficulties will begin to manifest in a greater number of our population. Recent advances in the evaluation of normal and abnormal swallowing make possible more precise anatomical and physiological diagnoses. Coupled with an understanding of swallowing physiology, such detailed evaluation allows greater opportunity to safely manage dysphagia with directed therapy and appropriate surgical intervention. The current study is a discussion of the changes that occur in deglutition with normal aging, contemporary evaluation of swallowing function, and some of the common causes of dysphagia in elderly patients.

ACESSE O PERIÓDICO

Dysphagia Characteristics in Zenker’s Diverticulum

Bergeron JL, Long JL, Chhetri DK.

Otolaryngol Head Neck Surg. 2012 Nov 5. [Epub ahead of print]

Abstract

ObjectivesTo evaluate dysphagia characteristics in patients with Zenker’s diverticulum (ZD).Study DesignCase series with chart review.SettingOutpatient tertiary care dysphagia clinic.Subjects and MethodsAll ZD cases surgically treated over a 6-year period were identified and reviewed for dysphagia history and dysphagia characteristics on initial presentation using fiber-optic endoscopic evaluation of swallowing (FEES). Dysphagia symptoms and swallowing abnormalities were compared across groups based on diverticulum size (small <1 cm, medium 1-3 cm, and large >3 cm).ResultsForty-six patients underwent a total of 52 procedures during the study period. ZD size was available in 49 cases (6 small, 26 medium, 17 large). Regurgitation symptoms were less frequent in patients with small (17%) compared with medium (68%) or large diverticula (76%; P = .03). Postswallow hypopharyngeal reflux (PSHR) was less frequent in patients with small (17%) compared with medium (91%) and large diverticula (87%; P < .01). PSHR was present on all FEES available for patients who presented with a recurrent or residual ZD (n = 7). In all cases, PSHR resolved after successful treatment of ZD. Pharyngeal residue indicating possible weakness was present in 24% of all patients at initial presentation.ConclusionsPreoperative assessment of dysphagia characteristics in ZD patients reveals that PSHR is predictive of a ZD larger than 1 cm and may be useful in surgical planning. PSHR is also helpful in identifying patients with recurrent or residual symptomatic ZD following surgical treatment. Pharyngeal weakness is present in a subset of ZD patients.

ACESSE O PERIÓDICO