TY  - CHAP
M1  - Book, Section
TI  - Transoral Cricopharyngeal Myotomy and Zenker Diverticulectomy
A1  - Hunter, John G.
A1  - Spight, Donn H.
A1  - Sandone, Corinne
A1  - Fairman, Jennifer E.
Y1  - 2018
N1  - 
T2  - Atlas of Minimally Invasive Surgical Operations
AB  - A  Zenker  diverticulum  is  a  pulsion  diverticulum  that  occurs  between  the  cricopharyngeus  muscle  inferiorly  and  the  inferior  constrictor  superiorly  as  a  result  of  relative  obstruction  to  swallowing  at  the  esophageal  introitus  by  a  “tight”  cricopharyngeus  muscle  (Figure  1A).  As  the  diverticulum  develops  and  extends  inferiorly  and  posteriorly,  the  cricopharyngeus  muscle  is  enveloped  by  mucosa  from  the  posterior  wall  of  the  esophageal  introitus  and  the  anterior  wall  of  the  diverticulum  (Figure  1B).  This  relationship  allows  transoral  division  of  the  common  wall  between  the  esophagus  and  diverticulum,  and  cricopharyngeal  myotomy  with  a  single  firing  of  a  linear  stapler  inserted  into  the  diverticulum  (one  jaw)  and  across  the  upper  esophageal  sphincter  (cricopharyngeus  muscle)  (Figure  1C).  An  important  anatomic  fact  that  supports  the  safe  performance  of  the  cricopharyngeal  myotomy  is  that  the  hypopharynx,  diverticulum,  and  cervical  esophageal  complex  are  surrounded  by  the  middle  layer  of  the  deep  cervical  fascia,  which  protects  against  leakage  into  the  mediastinum.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1162529952
ER  -