Killian Jamieson Diverticulum, the Great Mimicker: A Case Series and Contemporary Review.

Autor:	Howell R; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA., Tang A; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA., Allen J; Department of Surgery, University of Auckland, Auckland, New Zealand., Altaye M; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA., Amin M; Department of Otolaryngology-Head and Neck Surgery, New York University, New York, New York, USA., Bayan S; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA., Belafsky P; Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Davis, California, USA., Cervenka B; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA., deSilva B; Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, USA., Dion G; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA., Ekbom D; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA., Friedman A; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA., Fritz M; Department of Otolaryngology-Head and Neck Surgery, University of Kentucky, Lexington, Kentucky, USA., Giliberto JP; Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA., Guardiani E; Department of Otolaryngology-Head and Neck Surgery, Wake Forest University, Winston-Salem, North Carolina, USA., Harmon J; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA., Kasperbauer JL; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA., Khosla S; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA., Kim B; Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, USA., Kuhn M; Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Davis, California, USA., Kwak P; Department of Otolaryngology-Head and Neck Surgery, New York University, New York, New York, USA., Ma Y; Department of Otolaryngology-Head and Neck Surgery, University of California - San Francisco, San Francisco, California, USA., Madden L; Department of Otolaryngology-Head and Neck Surgery, Wake Forest University, Winston-Salem, North Carolina, USA., Matrka L; Department of Otolaryngology-Head and Neck Surgery, Ohio State University, Columbus, Ohio, USA., Mayerhoff R; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA., Piraka C; Department of Gastroenterology/Hepatology, Henry Ford Health System, Detroit, Michigan, USA., Rosen C; Department of Otolaryngology-Head and Neck Surgery, University of California - San Francisco, San Francisco, California, USA., Tabangin ME; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA., Wahab SA; Department of Radiology, University of Cincinnati, Cincinnati, Ohio, USA., Wilson K; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA., Wright SC; Department of Otolaryngology-Head and Neck Surgery, Wake Forest University, Winston-Salem, North Carolina, USA.; Department of Otolaryngology-Head and Neck Surgery, University of Maryland, Baltimore, Maryland, USA., Young V; Department of Otolaryngology-Head and Neck Surgery, University of California - San Francisco, San Francisco, California, USA., Yuen S; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA., Postma GN; Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University Health, Augusta, Georgia, USA.
Jazyk:	angličtina
Zdroj:	The Laryngoscope [Laryngoscope] 2023 Sep; Vol. 133 (9), pp. 2110-2115. Date of Electronic Publication: 2022 Dec 01.
DOI:	10.1002/lary.30508
Abstrakt:	Objective: To assess barium esophagram (BAS) as a diagnostic marker for patients with Killian Jamieson diverticula (KJD). Methods: 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. Results: 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). Conclusion: 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. Level of Evidence: 4 Laryngoscope, 133:2110-2115, 2023. (© 2022 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze:	MEDLINE
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