RESUMEN
BACKGROUND: Management of the pharyngeal pouch has evolved enormously since the first description by Ludlow in 1764 and the first case series by Zenker and Von Ziemssen in 1877. With the introduction of antibiotics, and the advancement of surgical technique with the advent of endoscopic surgery and lasers, current management is vastly different to that in the nineteenth century. OBJECTIVES: This paper traces the history of pharyngeal pouch management, and discusses the various treatment options and opinions recorded during the nineteenth and twentieth centuries, comparing these with techniques popular today. RESULTS AND CONCLUSION: Pharyngeal pouch surgery has been associated with significant morbidity, both because of the elderly age of patients typically affected by the condition and because of the surgery itself and potential post-operative complications encountered. The historical development of pharyngeal pouch management and the understanding of pharyngeal pouch pathophysiology are discussed.
Asunto(s)
Divertículo de Zenker/historia , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Procedimientos Quirúrgicos Otorrinolaringológicos/historia , Divertículo de Zenker/diagnóstico , Divertículo de Zenker/terapiaAsunto(s)
Esofagectomía/métodos , Divertículo de Zenker/complicaciones , Divertículo de Zenker/cirugía , Trastornos de Deglución/etiología , Trastornos de Deglución/cirugía , Esofagectomía/historia , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Radiografía , Resultado del Tratamiento , Divertículo de Zenker/diagnóstico por imagen , Divertículo de Zenker/historiaRESUMEN
Zenker's diverticulum is a rare anatomic defect that physicians have confronted for almost 250 years. Its location at the interface of the pharynx, neck, and mediastinum makes surgical access difficult and risks severe morbidity. Minimally invasive endoscopic surgical repair of Zenker's diverticulum has been attempted for more than a century as an alternative to reduce morbidity of an open transcervical approach. However, limitations due to available antibiotics, instrumentation, and laryngoscopes, as well as a general discomfort with a sutureless closure of the mucosal excision, have delayed widespread adoption of minimally invasive repair until the last 10 to 15 years. This manuscript will detail the historical evolution of endoscopic surgical therapy for Zenker's diverticulum and highlight the work of two otolaryngologists, Chevalier Jackson and Gosta Dohlman, who were critical in advancing the surgical technique and reducing morbidity. Lastly, this manuscript will analyze the delay in widespread application of endoscopic surgical repair of Zenker's diverticulum.