台耳醫誌

Esophagus Killian-Jamieson diverticulum (KJD) is a rare pharyngoesophageal diverticulum, originating inferior to the cricopharyngeus muscle and residing anterolaterally to the esophagus. A 54 y/o woman complained of experiencing dysphagia with a lumpy sensation at the level of the thyroid gland, as well as regurgitation for several months, particularly after solid food intake. A flexible laryngoscopy revealed no lesions at the upper aerodigestive tract. Esophageal diverticulum was suspected, and a cervical CT revealed a focal lesion with air posterior to the left lobe of the thyroid gland. An esophagography revealed a contrast-filled outpouching over the left anterolateral aspect of the esophageal wall at the C6-C7 level, which resulted in a diagnosis of KJD. Because KJD was close to the recurrent laryngeal nerve (RLN), the patient received a transcervical diverticulum resection with intra-operative neuro-monitoring (IONM). The patient's symptoms subsequently subsided, and there was no diverticulum recurrence after 12 months of follow-up. Although KJD is rare and mimics a thyroid tumor, the diagnosis could be confirmed through an esophagography. We recommended that the diverticulum should be removed transcervically under the guidance of IONM to avoid injuring the recurrent laryngeal nerve.
(J Taiwan Otolaryngol Head Neck Surg 2021; 56:253-258)