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Invited Commentary
Clinical Controversies in Otolaryngology
April 2016

Zenker Diverticulum and Clinical Controversies in OtolaryngologyWhich Surgical Approach Is Superior?

Author Affiliations
  • 1Duke University Health System, Durham, North Carolina
JAMA Otolaryngol Head Neck Surg. 2016;142(4):403-404. doi:10.1001/jamaoto.2015.3387

Those of us trained a generation or more ago were witness to an intense effort to provide minimally invasive surgical approaches designed to reduce the adverse effects on patients, whether through miniaturization of instruments, development and implementation of endoscopes and microscopes, or advances in perioperative supportive care. Evidence that these effects have been significant across the spectrum of surgical care include examples such as endoscopic sinus surgery and laparoscopic cholecystectomy. This revolution in surgical care has likewise had an effect on other upper aerodigestive tract diseases, including Zenker diverticulum (ZD). The use of endoscopic minimally invasive techniques to treat patients with this disorder has been readily adopted and adapted by surgeons across the world, returning to the basics of Mosher’s original endoscopic treatment approach.1 In the United States, where the accepted approach was external diverticulectomy for most of the past 80-plus years, adoption of endoscopic treatment has had an especially dramatic clinical change.

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