Killian's triangle

 Q: 55 years old male is admitted to ICU with aspiration pneumonia. The patient reports issue with swallowing - associated with gurgling sounds and mass in the neck.  CT scan of the neck reads weakness in the Killian's triangle. What is Killian's triangle? 

 Answer: Killian's triangle, also known as Killian dehiscence, is a triangular-shaped area of muscular weakness in the wall of the pharynx, between the transverse fibers of the cricopharyngeus muscle and the oblique fibers of the lower inferior constrictor (thyropharyngeus) muscle. 

Clinical significance: It is the site of Zenker's diverticulum (ZD). ZD is an upper esophageal sac-like outpouching of the mucosa and submucosa.

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References:

1. Tabola R, Lewandowski A, Cirocchi R, et al. Zenker diverticulum: Experience in surgical treatment of large diverticula. Medicine (Baltimore). 2018;97(19):e0557. doi:10.1097/MD.0000000000010557 

2.  Kensing KP, White JG, Korompai F, Dyck WP. Massive bleeding from a Zenker's diverticulum: case report and review of the literature. South Med J 1994; 87:1003. 

3. Herbella FA, Dubecz A, Patti MG. Esophageal diverticula and cancer. Dis Esophagus 2012; 25:153. 

4. Bowdler DA, Stell PM. Carcinoma arising in posterior pharyngeal pulsion diverticulum (Zenker's diverticulum). Br J Surg 1987; 74:561.