The cricopharyngeus muscle has a tendinous inferior margin where it attaches to the cricoid cartilage, and a superior dehiscence zone (Killian's dehiscence) between the oblique and transverse fibres where the posterior pharyngeal wall is thin and vulnerable to Zenker's diverticulum formation.
Killian's dehiscence in the cricopharyngeus tendinous-muscular junction is the anatomical weak point through which Zenker's diverticulum herniates. Endoscopic stapling of the cricopharyngeal bar (the posterior cricopharyngeus ridge) divides the muscle and septum between the pharyngeal lumen and the diverticulum, effectively eliminating the functional obstruction. This structure is the primary target in both endoscopic and open Zenker's repair.
Posterior pharyngeal mucosa herniation through the weak cricopharyngeus tendinous zone (Killian's triangle) producing progressive dysphagia and regurgitation of undigested food, treated by cricopharyngeal myotomy.
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