Starting in her early 70s, Mary Jane Wurtz, 77, of Winfield, Ill., noticed bits of undigested food coming into her mouth when she would lie down at night. It was unpleasant and annoying, but she did not think much about it and did not ask her doctor. One day, while looking up something in a medical encyclopedia, Wurtz happened to see a description of Zenker´s diverticulum. A light bulb went off in her mind; this could explain her problem. The discovery led her to her doctor and eventually to Loyola University Health System (Loyola) for a high-tech laser procedure that corrected her condition with less pain and a quicker recovery time than traditional surgery, which requires entering through the neck.
Zenker´s diverticulum is basically a hernia inside the throat. A small pouch bulges out between the mouth and the esophagus, which can cause swallowing problems, regurgitation after eating, a feeling of food sticking in the throat, chronic coughing, unexplained weight loss, bad breath and a gurgling noise in the neck. Difficulty swallowing is the symptom that prompts most patients to see their doctors. Many of the symptoms may be considered simply annoying and be ignored for years. However, about one-third of patients can get pneumonia from bits of food sneaking into their lungs.
The condition affects about 1 percent of the U.S. population, and occurs more frequently in men than women. Most people who seek treatment are in their 70s or 80s.
Wurtz´s physician diagnosed the problem with a special X-ray test called a barium swallow and explained that the standard treatment was surgery through the neck. Because of her age and because her condition was not severe, Wurtz and her doctor decided to watch and wait.
After several more years, Wurtz´s symptoms had gradually progressed, and she began to research her options. She learned about an endoscopic stapling technique that was available in North Carolina and wrote letters to Chicago-area medical centers to see if any offered that treatment. She received a reply from Guy J. Petruzzelli, M.D., Ph.D., at Loyola, who said “we do something better.’
An otolaryngologist and head and neck surgeon, Petruzzelli is one of the few surgeons nationwide who uses laser surgery to correct Zenker´s diverticulum. Also, he and his colleagues at Loyola are the only group of otolaryngologists in Chicago using the same kind of laser surgery to treat patients with cancer of the throat and larynx; they have treated more than 200 cancer patients with this technique.
Petruzzelli reaches the throat hernia or tumor through the patient´s mouth, so no incision in the neck is needed. With a laser and a microscope, he is able to achieve better precision and cause less damage to throat muscles than would be possible using traditional surgical methods. The technique also allows for better identification and more complete removal of tumors. A shorter hospital stay and an earlier return to work are added advantages to patients.
The less invasive procedure is important particularly for older adults like Wurtz who often are not good candidates for open surgery. She had surgery at Loyola last July and was back home and able to drink liquids the next day. Now, she is happy to have that annoying problem behind her.
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