Zenker's diverticulum is a pharyngoesophageal outpouching of mucosa and submucosa through Killian's dehiscence.

To investigate the propensity for Zenker's diverticulum to occur on the left side by examining muscle thickness in Killian's dehiscence, and to explore correlations between muscle thickness, sex, height and age.

The study included 109 Caucasian cadavers, 52 male and 57 female. The mean thickest and thinnest measurements of left medial, left lateral, right medial and right lateral aspects of Killian's dehiscence were calculated. The paired student's t-test was used to determine significance.

The average left muscle layer was significantly thinner than the right muscle layer, in both medial and lateral aspects. Furthermore, medial muscle thickness was significantly thinner than its respective lateral aspect for both the left and right sides. No correlations were found between muscle thickness and cadavers’ sex, length or stature, or age.

There was a significant difference in muscle thickness between the left and right sides of Killian's dehiscence. The findings suggest there is a reason why Zenker's diverticulum occurs predominantly on the left side. The study also showed a significant difference in muscle thickness between the medial and lateral aspects of Killian's triangle.

Pharyngeal pouches have been recognised as a cause of dysphagia for centuries and have been treated in a variety of ways over that time.

This article aimed to analyse the results of surgery by a variety of techniques, as performed by one surgeon.

A retrospective analysis of a case series was conducted, analysing the variables of patient age, sex, type of surgery, length of hospital stay, leak, recurrence and other complications.

A total of 121 patients were treated by 135 operations. There were no leaks in the group treated by endoscopic stapling and this group also had a significantly shorter hospital stay. As for recurrence, the lowest rate appeared to be in the group treated by excision of the pouch.

The techniques used by the author all still seem to have a role in the management of pharyngeal pouch, with the endoscopic stapling approach associated with a low rate of complications and short hospital stay.

We report identical twins with Zenker's diverticulum.

Case report and literature review.

Geographical and racial variation in occurrence, and rare familial cases, suggest that inherited factors play a role in the pathogenesis of Zenker's diverticulum. The identical twins reported here provide further evidence supporting a genetic predisposition.

To evaluate endoscopic pharyngeal pouch surgery practice in north Glasgow by comparing it to National Institute for Health and Clinical Excellence recommendations.

We reviewed the case notes of patients who had undergone pharyngeal pouch surgery from 1998 to 2008. Data obtained included patient demographics, procedures performed, complications and outcomes.

One hundred patient case notes were reviewed. Surgical procedures performed included endoscopic stapling (n = 58), endoscopic laser surgery (26), external excision (one), cricopharyngeal myotomy (two) and pharyngoscopy with dilatation (three). Endoscopic stapling was abandoned in 10 patients (14.7 per cent), three of whom declined further surgery. There was a 2.2 per cent perforation rate for endoscopic procedures. Twenty-one per cent of patients required further surgery.

Our practice was not in keeping with National Institute for Health and Clinical Excellence recommendations. Our complication rates were similar to other published series, although our rates for abandoned and revision procedures were higher. We suggest that pharyngeal pouch surgical procedures should be undertaken only by otolaryngologists with a primary head and neck interest.