PAEA Surgery End Of Rotation (EOR) Practice Exam

What are the two main treatment options for Zenker's diverticulum?

1. Medications and lifestyle changes

2. Diverticulectomy and cricopharyngeus myotomy

3. Endoscopic dilation and stenting

4. Radiation therapy and chemotherapy

The correct answer is: Diverticulectomy and cricopharyngeus myotomy

The primary treatment options for Zenker's diverticulum focus on addressing the underlying dysfunction that leads to the formation of the diverticulum and alleviating the symptoms experienced by the patient, such as dysphagia (difficulty swallowing). Diverticulectomy involves surgically excising the diverticulum, which can effectively remove the abnormal pouch that forms in the esophagus. The cricopharyngeus myotomy is a procedure that relaxes the cricopharyngeus muscle, which is often hypertonic in these patients, contributing to swallowing difficulties. By performing this muscle division, there is improved passage of food through the esophagus into the stomach. Treatment options like medications and lifestyle changes are less effective for Zenker's diverticulum, as the condition is anatomical rather than purely symptomatic. While endoscopic dilation and stenting can be useful in certain cases, especially for palliation, they are not definitive treatments. Radiation therapy and chemotherapy are not relevant therapies for Zenker's diverticulum, as this condition is not cancerous in nature. Thus, diverticulectomy combined with cricopharyngeus myotomy provides a comprehensive approach to resolving both the diverticulum and the functional dysphagia, leading to improved patient outcomes.