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What is Zenker’s Diverticulum?
July 3, 2019
- A diverticulum is a side pocket that forms when pharyngeal or esophageal muscle herniates.
- On X-ray, the diverticulum appears as a round balloon that fills with radiopaque material as the patient swallows. After the swallow, the diverticulum usually empties of material (Logemann, 1998)
Prevalence
- Ranging between 0.01 to 0.11% (U.S.)
- 1-2 per 100,000 patients/year.
- Twice as common in males.
- Typically occurs in middle-aged and elderly patients
Symptoms
- 80 – 90% of patients complain of dysphagia
- Regurgitation of undigested foods
- Halitosis (bad breath)
- Hoarseness
- Reflux
- 30-40% of patients describe chronic cough and repeated episodes of aspiration, some with aspiration pneumonia
(Ferreira, Simmons, & Baron, 2007)
Generally treatment for esophageal disorders is surgical or medical.
| Sno. | External | Endoscopic |
|---|---|---|
| 1. | Making an incision on the neck
|
Done through the mouth |
| 2. | Longer Procedure | The mucosa or muscle that make up the third party wall are divided with an electrocautery laser or an automatic stapler.
|
| 3. | Longer Hospital Stay (5-7 days) | Shorter Procedure |
| 4. | NG feeds (5 days) | Shorter Hospital Stay (1-2 days) |
| 5. | Oral intake within 24 hours |
(Siddiq, Sood, & Strachan, 2001)
SLP Treatment
- Compensatory Treatment Procedures
- Control the flow of food and eliminate the patient’s symptoms (aspiration)
- Postural Techniques
- Modifying volume and speed of food presentation
- Food Consistency (Diet) Changes
- Control the flow of food and eliminate the patient’s symptoms (aspiration)
- Follow Aspiration Precautions
- Good Oral Hygiene
(Asofsky, 2017)
Pre-Counseling
- During preoperative counseling the speech pathologist will address aspects of care.
- These include strategies for:
- Effective symptom management
- Safety issues
- Nutritional and speech therapy support
- Coping strategies (Cady, 2002).
- Explain what the surgery is and possible dietary changes – NG tube or soft consistency diet
- Counsel the patient and answer their questions or concerns.
– Angie
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