Researchers practice new way of repairing rare throat obstructions


Trouble swallowing and breathing, a sore throat and unexplained weight loss are all indicators of Zenker’s diverticulum – pouches that develop in the throat and are made up of muscle tissue and mucus membrane. It is a pocket in which food collects, and its potential for rapid growth can have devastating results.

“Instead of food going straight down the esophagus, it tends to go into the sac,” said Frank Miller, M.D., associate professor of otolaryngology – head and neck surgery at the Health Science Center. “It grows and presses on the esophagus, making it very painful.”

Dr. Miller and his team may be the only group in San Antonio to use an endoscopic, minimally-invasive technique to remove the sac that grows on the esophagus, most commonly affecting the elderly. They have performed the new procedure on more than 40 people in the last five years and will present the results of their five-year study in May at the Triological Society Meeting in Chicago, Ill.

“This technique allows us to give the patient a general anesthetic and insert the endoscopic instrument into the throat to reach the diverticula sac,” Dr. Miller said. “We then use either a laser or endoscopic stapler and transect the wall that connects the sac to the esophagus, allowing it to retreat. A telescope attached to a television monitor is also inserted into the throat, allowing us to see the area on a computer screen. The entire procedure takes approximately 45 minutes and the patient is generally in and out of the hospital within a couple of days.”

The older (traditional) open-surgical technique to remove the pouch leaves the patient in the hospital for about a week, unable to eat for several days and the patient also has an increased risk of post-operative infection.

The most dangerous symptom of having Zenker’s diverticulum is aspiration, in which food or liquid enters the unprotected airway. As the diverticulum enlarges, obstruction of the esophagus can occur. Other symptoms include gurgling noises in the neck, bad breath, coughing after eating and the feeling of food sticking in the throat.

Although the cause of Zenker’s diverticulum is unknown, there are several theories – many of them having to do with bodily changes due to aging.

“We hope this will become the common method for treating patients,” Dr. Miller said.

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