Single-Center Evaluation of Clinical Results After Modified Transoral Septotomy

Objective: The standard treatment for Zenker's diverticulum (ZD) is transoral septotomy, which has evolved to include techniques such as septal traction to improve outcomes. This study reports the clinical results from our center using a modified transoral septotomy (MTS). Methods: From 2023 to 2025, 21 patients with ZD were treated with MTS at our center. A dysphagia screening questionnaire was utilized to assess the frequency and severity of dysphagia and regurgitation. All patients underwent a surgical examination, preoperative endoscopy, and preoperative barium swallow. This prospective study aimed to evaluate the outcomes of MTS in treatment-naïve and recurrent ZD cases, highlighting the technique's appeal due to its minimally invasive nature and enhanced patient outcomes. Results: Among the 21 patients (16 males, 5 females, median age 82.5 years, interquartile range (IQR): 61–80), symptom scores improved from a median of 12 (IQR: 10–16) pre-surgery to 0 (IQR: 0–2) post-surgery (p < 0.00001). Post-procedure, 87% of patients were completely asymptomatic, with a total failure rate of 5%. The treatment was successful in 95% of patients overall and in 100% of those with recurrent ZD. Conclusion: Despite inherent study limitations, modified transoral septotomy significantly improves treatment outcomes for ZD patients. Level of Evidence: 2 (observational study with significant effect)—Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence.