Killian Jamieson Diverticulum, the Great Mimicker: A Case Series and Contemporary Review.
CPMD
Killian Jamieson
Zenker diverticulum
cricopharyngeus bar
cricopharyngeus dysfunction
cricopharyngeus muscle dysfunction
hypopharyngeal diverticulum
pharyngoesophageal dysphagia
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
revised:
12
10
2022
received:
31
05
2022
accepted:
14
10
2022
medline:
11
8
2023
pubmed:
2
12
2022
entrez:
1
12
2022
Statut:
ppublish
Résumé
To assess barium esophagram (BAS) as a diagnostic marker for patients with Killian Jamieson diverticula (KJD). Prospective, multicenter cohort study of individuals enrolled in the Prospective OUtcomes of Cricopharyngeus Hypertonicity (POUCH) Collaborative. Patient demographics, comorbidities, radiographic imaging reports, laryngoscopy findings, patient-reported outcome measures (PROM), and operative reporting were abstracted from a REDCap database and summarized using means, medians, percentages, frequencies. Paired t-tests and Wilcoxon Signed Rank test were used to test pre- to post-operative differences in RSI, EAT-10, and VHI-10 scores. Diagnostic test evaluation including sensitivity, specificity, positive, and negative predictive value with 95% confidence intervals were calculated comparing BAS findings to operative report. A total of 287 persons were enrolled; 13 (4%) patients were identified with confirmed KJD on operative reports. 100% underwent open transcervical excision. BAS has a 46.2% (95% confidence interval [CI]: 23.2, 70.9) sensitivity and 97.8% (95% CI: 95.3, 99.0) specificity in detecting a KJD and 50% (95% CI: 25.4, 74.6) positive predictive value but 97.4% (95%CI: 94.8, 98.7) negative predictive value. Preoperatively, patients reported mean (SD) RSI and EAT-10 of 19.4 (9) and 8.3 (7.5) accordingly. Postoperatively, patients reported mean (SD) RSI and EAT-10 as 5.4 (6.2) and 2.3 (3.3). Both changes in RSI and EAT-10 were statistically significant (p = 0.008, p = 0.03). KJD are rare and represent <5% of hypopharyngeal diverticula undergoing surgical intervention. Open transcervical surgery significantly improves symptoms of dysphagia. BAS has high specificity but low sensitivity in detecting KJD. 4 Laryngoscope, 133:2110-2115, 2023.
Types de publication
Multicenter Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2110-2115Informations de copyright
© 2022 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.
Références
BATSON OV. The cricopharyngeus muscle. Ann Otol Rhinol Laryngol. 1955;64(1):47-54. https://doi.org/10.1177/000348945506400108.
Ludlow A. A case of obstructed deglutition from a preternatural dilation of and bag formed in the pharynx. Med Observ Inquir. 1769;3:85-101.
Zenker FA, von Ziemssen H. Dilatations of the esophagus. Cyclop Pract Med. 1878;3:46-48.
Killian G. Über den mund der speiseröhre. Zeitschrift für Ohrenheilkunde. 1908;55:1-44.
Jamieson EB. Illustrations of Regional Anatomy. Edinburg: E&S Livingstone Ltd; 1934.
Ekberg O, Nylander G. Lateral diverticula from the pharyngo-esophageal junction area. Radiology. 1983;146(1):117-122. https://doi.org/10.1148/radiology.146.1.6401363.
Zaino C, Jacobson HG, Lepow H, Ozturk C. The pharyngoesophageal sphincter. Radiology. 1967;89(4):639-645. https://doi.org/10.1148/89.4.639.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377-381. https://doi.org/10.1016/j.jbi.2008.08.010.
Belafsky PC, Mouadeb DA, Rees CJ, et al. Validity and reliability of the eating assessment tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919-924. https://doi.org/10.1177/000348940811701210.
Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reflux symptom index (RSI). J Voice. 2002;16(2):274-277. https://doi.org/10.1016/S0892-1997(02)00097-8.
Rosen CA, Lee AS, Osborne J, Zullo T, Murry T. Development and validation of the voice handicap index-10. Laryngoscope. 2004;114(9):1549-1556. https://doi.org/10.1097/00005537-200409000-00009.
Leonard R, Rees CJ, Belafsky P, Allen J. Fluoroscopic surrogate for pharyngeal strength: the pharyngeal constriction ratio (PCR). Dysphagia. 2011;26(1):13-17.
Neubauer PD, Rademaker AW, Leder SB. The Yale pharyngeal residue severity rating scale: an anatomically defined and image-based tool. Dysphagia. 2015;30(5):521-528. https://doi.org/10.1007/s00455-015-9631-4.
Dean AG, Sullivan KM, Soe MM. OpenEpi: Open source epidemiologic statistics for public health, version. www.OpenEpi.com. 2013.
Yücel L, Isayev N, Beton S, Gökcan MK, Küçük TB. Incidentally found Killian-Jamieson diverticulum during thyroidectomy: a case report. Ear Nose Throat J. 2021;145561321989433. https://doi.org/10.1177/0145561321989433.
Undavia S, Anand SM, Jacobson AS. Killian-jamieson diverticulum: a case for open transcervical excision. Laryngoscope. 2013;123(2):414-417. https://doi.org/10.1002/lary.23639.
O'Rourke AK, Weinberger PM, Postma GN. Killian-jamieson diverticulum. Ear Nose Throat J. 2012;91(5):196. https://doi.org/10.1177/014556131209100507.
Haddad N, Agarwal P, Levi JR, Tracy JC, Tracy LF. Presentation and management of Killian Jamieson diverticulum: a comprehensive literature review. Ann Otol Rhinol Laryngol. 2020;129(4):394-400. https://doi.org/10.1177/0003489419887403.
Kim J, Kim YJ, Kim EK, Park CS. Incidentally found pharyngoesophageal diverticulum on ultrasonography. Yonsei Med J. 2002;43(2):271-273. https://doi.org/10.3349/ymj.2002.43.2.271.
Pang JC, Chong S, Na HI, Kim YS, Park SJ, Kwon GY. Killian-jamieson diverticulum mimicking a suspicious thyroid nodule: sonographic diagnosis. J Clin Ultrasound. 2009;37(9):528-530. https://doi.org/10.1002/jcu.20607.
Schmitt W, Germano A. Killian-jamieson diverticulum mimicking a suspicious thyroid lesion. Clin Case Rep. 2018;6(12):2509-2510. https://doi.org/10.1002/ccr3.1833.
Kasle DA, Torabi SJ, Boey H, Sasaki CT. Hypopharyngeal diverticulum: toward a unified understanding of its etiopathogenesis. Dysphagia. 2019;34(5):713-715. https://doi.org/10.1007/s00455-019-10030-z.
Stewart KE, Smith DRK, Woolley SL. Simultaneously occurring zenker's diverticulum and Killian-Jamieson diverticulum: case report and literature review. J Laryngol Otol. 2017;131(8):661-666. https://doi.org/10.1017/S0022215117001268.
Lee CK, Chung IK, Park JY, et al. Endoscopic diverticulotomy with an isolated-tip needle-knife papillotome (iso-tome) and a fitted overtube for the treatment of a Killian-Jamieson diverticulum. World J Gastroenterol. 2008;14(42):6589-6592. https://doi.org/10.3748/wjg.14.6589.
Yun PJ, Huang HK, Chang H, Lee SC, Huang TW. Endoscopic diverticulotomy with a stapler can be an effective and safe treatment for Killian-Jamieson diverticulum. J Thorac Dis. 2017;9(9):E787-E791. https://doi.org/10.21037/jtd.2017.08.14.
Modayil RJ, Zhang X, Ali M, Das K, Gurram K, Stavropoulos SN. Endoscopic diverticulotomy for Killian-Jamieson diverticulum: mid-term outcome and description of an ultra-short tunnel technique. Endosc Int Open. 2022;10(1):E119-E126. https://doi.org/10.1055/a-1548-5552.
Alnimer L, Zakaria A, Piper M. Killian jamieson diverticulum: a rare cause of dysphagia. Cureus. 2021;13(3):e13654. https://doi.org/10.7759/cureus.13654.
Killian G. Ueber den mund der speiserohre. Zeitschritft fur Ohrenheilkunde. 1908;55:1-41.
Johnson CM, Postma GN. Zenker diverticulum-which surgical approach is superior? JAMA Otolaryngol Head Neck Surg. 2016;142(4):401-403.
Johnson CM, Postma GN. Not all pharyngeal pouches are created equal: management of “non-zenker” hypopharyngeal diverticula. Operat Techniq Otolaryngol Head Neck Surg. 2016;27(2):80-85.
Leonard R, Belafsky P, McKenzie S. Pharyngeal adaptation in zenker's diverticulum: the “faux pharyngoesophageal segment”. Otolaryngol Head Neck Surg. 2008;139(3):424-428. https://doi.org/10.1016/j.otohns.2008.06.009.
Kakaje A, Alhalabi MM, Alyousbashi A, Ghareeb A. Allergic rhinitis, asthma and laryngopharyngeal reflux disease: a cross-sectional study on their reciprocal relations. Sci Rep. 2021;11(1):2870-2871. https://doi.org/10.1038/s41598-020-80793-1.
Hamizan AW, Choo YY, Loh PV, et al. The association between the reflux symptoms index and nasal symptoms among patients with non-allergic rhinitis. J Laryngol Otol. 2021;135(2):142-146. https://doi.org/10.1017/S0022215120002492.
Jiang N, Sung CK, Damrose EJ. Improvement in the reflux symptom index following surgery for cricopharyngeal dysfunction. J Voice. 2017;31(1):86-89. https://doi.org/10.1016/j.jvoice.2016.02.006.
Rubesin SE, Levine MS. Killian-jamieson diverticula: radiographic findings in 16 patients. AJR Am J Roentgenol. 2001;177(1):85-89.