Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-20T13:43:28.929Z Has data issue: false hasContentIssue false
  • English
  • Français

Why do Zenker's diverticulae occur more often on the left than the right side?

Published online by Cambridge University Press:  03 June 2019

N A Fitchat ,
S Maharaj  and
M O Kwete
N A Fitchat
Affiliation:
Department of Otorhinolaryngology, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
S Maharaj*
Affiliation:
Department of Otorhinolaryngology, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
M O Kwete
Affiliation:
Department of Otorhinolaryngology, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
*
Author for correspondence: Dr Shivesh Maharaj, Department of Otorhinolaryngology, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Zenker's diverticulum is a pharyngoesophageal outpouching of mucosa and submucosa through Killian's dehiscence.

Objective

To investigate the propensity for Zenker's diverticulum to occur on the left side by examining muscle thickness in Killian's dehiscence, and to explore correlations between muscle thickness, sex, height and age.

Methods

The study included 109 Caucasian cadavers, 52 male and 57 female. The mean thickest and thinnest measurements of left medial, left lateral, right medial and right lateral aspects of Killian's dehiscence were calculated. The paired student's t-test was used to determine significance.

Results

The average left muscle layer was significantly thinner than the right muscle layer, in both medial and lateral aspects. Furthermore, medial muscle thickness was significantly thinner than its respective lateral aspect for both the left and right sides. No correlations were found between muscle thickness and cadavers’ sex, length or stature, or age.

Conclusion

There was a significant difference in muscle thickness between the left and right sides of Killian's dehiscence. The findings suggest there is a reason why Zenker's diverticulum occurs predominantly on the left side. The study also showed a significant difference in muscle thickness between the medial and lateral aspects of Killian's triangle.

Keywords

Deglutition DisordersPharyngeal MusclesZenker's Diverticulum
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 6 , June 2019 , pp. 515 - 519
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr S Maharaj takes responsibility for the integrity of the content of the paper

References

1Sen, P, Kumar, G, Bhattacharyya, A. Pharyngeal pouch: associations and complications. Eur Arch Otorhinolaryngol 2006;263:463–810.1007/s00405-005-1036-9Google Scholar
2Prisman, E, Genden, E. Zenker diverticulum. Otolaryngol Clin North Am 2013;46:1101–1110.1016/j.otc.2013.08.011Google Scholar
3Law, R, Katzka, D, Baron, T. Zenker's diverticulum. Clin Gastroenterol Hepatol 2014;12:1773–82Google Scholar
4Siddiq, M. Pharyngeal pouch (Zenker's diverticulum). Postgrad Med J 2001;77:506–11Google Scholar
5Nguyen, H, Urquhart, A. Zenker's diverticulum. Laryngoscope 1997;107:1436–4010.1097/00005537-199711000-00003Google Scholar
6Ferreira, L, Simmons, D, Baron, T. Zenker's diverticula: pathophysiology, clinical presentation, and flexible endoscopic management. Dis Esophagus 2008;21:1–8Google Scholar
7van Overbeek, J. Pathogenesis and methods of treatment of Zenker's diverticulum. Ann Otol Rhinol Laryngol 2003;112:583–9310.1177/000348940311200703Google Scholar
8Statstutor. Statistics: 1.1 Paired t-tests. In: http://www.statstutor.ac.uk/resources/uploaded/paired-t-test.pdf [11 February 2017]Google Scholar
9Statstutor. Pearson's correlation. In: http://www.statstutor.ac.uk/resources/uploaded/pearsons.pdf [11 February 2017]Google Scholar
10Statstutor. Statistical Analysis 5: Chi-squared (χ2) test for 2-way tables. In: http://www.statstutor.ac.uk/resources/uploaded/coventrychisquared.pdf [11 February 2017]Google Scholar
11Sasaki, C, Ross, D, Hundal, J. Association between Zenker diverticulum and gastroesophageal reflux disease: development of a working hypothesis. Am J Med 2003;115:169–7110.1016/S0002-9343(03)00218-3Google Scholar
12Cook, I, Bumbergs, P, Cash, K, Jamieson, G, Shearman, D. Structural abnormalities of the cricopharyngeus muscle in patients with pharyngeal (Zenker's) diverticulum. J Gastroenterol Hepatol 1992;7:556–6210.1111/j.1440-1746.1992.tb01485.xGoogle Scholar
13Cavelaars, A, Kunst, A, Geurts, J, Crialesi, R, Grötvedt, L, Helmert, U et al. Persistent variations in average height between countries and between socio-economic groups: an overview of 10 European countries. Ann Hum Biol 2000;27:407–2110.1080/03014460050044883Google Scholar
14Westrin, K, Ergün, S, Carlsöö, B. Zenker's diverticulum–a historical review and trends in therapy. Acta Otolaryngol 1996;116:351–6010.3109/00016489609137857Google Scholar
15Stafford, N, Moore-Gillon, V, McKelvie, P. Handedness and the side on which pharyngeal pouches occur. BMJ 1984;288:815–16Google Scholar
16Ruiz-Tovar, J, Pérez de Oteyza, J, Collado, M, Rojo, R, García-Villanueva, A. 20 years' experience in the management of Zenker's diverticulum in a third-level hospital. Rev Esp Enferm Dig 2006;98:429–3510.4321/S1130-01082006000600004Google Scholar