Bilateral vocal fold paresis after endoscopic stapling diverticulotomy for Zenker's diverticulum.

Abstract

Zenker's diverticulum may be treated with a variety of surgical techniques. Endoscopic methods, specifically endoscopic stapling diverticulotomy, have gained increasing acceptance because of shorter operative times, decreased morbidity, with shorter hospital stays and time to resumption of oral feedings. We report the occurrence of bilateral vocal fold paresis after endoscopic stapling diverticulotomy for Zenker's diverticulum, previously unreported in the literature. This complication likely resulted from traction on the recurrent laryngeal nerves secondary to unfavorable patient anatomy. Endoscopic stapling diverticulotomy is a safe and effective treatment method for Zenker's diverticulum and remains our procedure of choice for most patients. However, inability to safely expose the diverticulum endoscopically results in a significant abandonment rate for attempted procedures and may result in significant postoperative complications.