A pharyngoesophageal (Zenker) diverticulum is an outpouching of mucosa through a natural area of muscular weakness in the pharyngeal wall. Through which anatomical interval does it herniate?
- A Between the inferior constrictor and the cricopharyngeus
- B Between the superior and middle pharyngeal constrictors
- C Between the thyropharyngeus and cricopharyngeus parts of the inferior constrictor ✓
- D Through the cricothyroid membrane
Correct answer: C. Between the thyropharyngeus and cricopharyngeus parts of the inferior constrictor
Explanation
Zenker diverticulum is a pulsion pseudodiverticum herniating through Killian dehiscence, the gap between the oblique thyropharyngeus fibres and the transverse cricopharyngeus fibres of the inferior constrictor. The underlying problem is incomplete or incoordinated cricopharyngeal relaxation raising intraluminal pressure. Option A describes the Killian-Jamieson space below the cricopharyngeus, which gives lateral cervical oesophageal diverticula, the classic tempting distractor.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
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