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

• Published in: The Laryngoscope 2023-09, Vol.133 (9), p.2110-2115
• Main Authors: Howell, Rebecca, Tang, Alice, Allen, Jacqui, Altaye, Mekibib, Amin, Milan, Bayan, Semirra, Belafsky, Peter, Cervenka, Brian, deSilva, Brad, Dion, Greg, Ekbom, Dale, Friedman, Aaron, Fritz, Mark, Giliberto, John Paul, Guardiani, Elizabeth, Harmon, Jeffrey, Kasperbauer, Jan L., Khosla, Sid, Kim, Brandon, Kuhn, Maggie, Kwak, Paul, Ma, Yue, Madden, Lyndsay, Matrka, Laura, Mayerhoff, Ross, Piraka, Cyrus, Rosen, Clark, Tabangin, Meredith E., Wahab, Shaun A., Wilson, Keith, Wright, S. Carter, Young, Vyvy, Yuen, Sonia, Postma, Gregory N.
• Format: Article
• Language: English
• Subjects: CPMD; cricopharyngeus bar; cricopharyngeus dysfunction; cricopharyngeus muscle dysfunction; hypopharyngeal diverticulum; Killian Jamieson; Laryngoscopy; Patients; pharyngoesophageal dysphagia; Zenker diverticulum
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.30508

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 ed 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