Zenker’s Diverticulectomy/Cricopharyngeal Myotomy Postoperative Care Instructions

The cricopharyngeus muscle (CP) is located at the top of our esophagus (food pipe). Our bodies keep it contracted to stop food from coming back up into our throats. When we swallow, the CP relaxes to let the food pass. When the CP does not relax, food gets stuck. We feel it in the back of our throats. This is known as CP achalasia. Sometimes a pouch, called a Zenker’s Diverticulum, can form just above the muscle. To help us swallow, surgeons cut the CP either by working through our mouth (endoscopic) or by making an incision in our neck (open).

After Surgery Care

Incision: If there is an incision in your neck, this will be covered with skin glue. You will need to keep this dry for 5 days. When you shower, cover this with a bandage, then remove the bandage after the shower and pat the incision dry. After the 5th day, you can shower normally and let the incision get wet. After the shower cover the incision with facial moisturizer or antibiotic ointment and rub in softly, do not produce pain. This will help the incision heal without scar tissue.

Drain: If there is a drain present, you will be asked to return to the office the following day for removal. Keep the drain site dry and do not get it wet in the shower.

Sleeping: Please sleep with your head and upper body elevated to 30 degrees on pillows.

Activity: Do not strain, do heavy lifting or hard exercise that involves the upper body for 2 weeks.

Diet: Once you are discharged you need to eat a mechanical soft diet. This includes any food, like pasta, fish, mashed potatoes that does not need to be cut or chewed. Swallowing may be more difficult after surgery for the first 2 to 4 weeks due to swelling in your throat.

Voice Use: In general you can speak when needed. Your voice will be hoarse or rough for 2 to 4 days. If it is not normal after this period, discuss it with your doctor on your first visit after surgery

Pain: Most patients find that regular Tylenol is effective to control pain. However, there will be a narcotic pain medication called in to your pharmacy that you should pick up to have on hand to use if the acetaminophen is not adequate

Do not drive, operate dangerous machinery, or do anything dangerous if you are taking narcotic pain medication (such as oxycodone, hydrocodone, morphine, etc.) This medication affects your reflexes and responses, just like alcohol.

Antibiotics: You may be prescribed antibiotics for 7 days depending on how the incisions close. Please take this as directed.

Call Your Surgeon If You Have…

  1. Any concerns. We would much rather that you call your surgeon then worry at home, or get into trouble.
  2. Fever over 101.5 degrees F.
  3. Foul smelling discharge from your incision.
  4. More than expected swelling of your neck.
  5. Increase warmth or redness around the incision.
  6. Pain in your neck or chest with breathing or swallowing that continues to increase instead of decrease.
  7. Problem urinating.
  8. If you have trouble breathing- you need to go directly to the emergency room without calling.

How to Call Your Surgeon

  1. If it is urgent due to bleeding or difficulty breathing, call 911 or go directly to the closest emergency room without calling ahead.
  2. If it is not urgent, please try to call the Laryngology office during clinic hours of 9 am to 5 pm, Monday-Friday. If you need to speak with someone after 5 pm or on a weekend, call the Laryngology office and the answering service will contact the doctor on-call to call you back.

Surgeon:
Mark Courey
9am - 5pm:
Raisa (8am-4pm) (212) 241-3468
Glorianne (212) 241-9105
After 5pm & Weekends:
(212) 241-9425

Surgeon:
Matthew Mori
9am - 5pm:
Jessica (917) 623-5296
Laryngology Office (212) 241-9425
After 5pm & Weekends:
(212) 241-9425

** Please call during office hours for questions related to appointments, prescription refills and lab results. **

Postoperative Appointments

These appointments will have been made for 3 months following the surgery. In addition to the office visits, a swallow study will be scheduled on the same day just before your second postoperative appointment. This appointment schedule will have been given to you with your preoperative packet of instructions. If you have misplaced this list of appointments, in general the first postoperative appointment is 6 days after your surgery. Please call the office to confirm this appointment. We will then provide the list of additional appointment dates at that visit.