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Radiologically guided balloon dilatation of neopharyngeal strictures following total laryngectomy and pharyngolaryngectomy: 21 years’ experience

Published online by Cambridge University Press:  20 October 2009

R L Harris ,
A Grundy  and
T Odutoye
R L Harris*
Affiliation:
Department of Otolaryngology, St George's Hospital, London, UK
A Grundy
Affiliation:
Department of Radiology, St George's Hospital, London, UK
T Odutoye
Affiliation:
Department of Otolaryngology, St George's Hospital, London, UK
*
Address for correspondence: Mr R L Harris, Department of Otolaryngology, St George's Hospital, Blackshaw Road, London SW17 OQT, UK. Fax: 0207 829 8644 E-mail: [email protected]
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Abstract

Objective:

To assess the efficacy of radiologically guided balloon dilatation for the treatment of dysphagia secondary to neopharyngeal strictures in patients who have undergone laryngectomy.

Study design:

Retrospective case series.

Subjects and methods:

Twenty consecutive patients with pharyngeal stricture and dysphagia following total laryngectomy or pharyngolaryngectomy. Patients underwent balloon dilatation of the stricture under radiological guidance. The main outcome measure was maintenance of swallowing.

Results:

Five patients gained relief of their dysphagia with one balloon dilatation only. Nine patients required more than one dilatation to maintain swallowing. Two patients had balloon dilatation procedures and stent insertion for palliative relief of dysphagia from known recurrent malignant disease. Three patients failed to maintain swallowing with repeat dilatations. No patients suffered any significant complications such as perforation.

Conclusions:

Radiologically guided balloon dilatation is minimally invasive and safe. It is well tolerated. It may be repeated frequently, and can successfully relieve pharyngeal strictures in patients who have undergone total laryngectomy or pharyngolaryngectomy.

Keywords

LaryngectomyPharyngectomyBalloon Dilatation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 2 , February 2010 , pp. 175 - 179
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented at the American Academy of Otolaryngology-Head and Neck Surgery Annual Meeting, 21–24 September 2008, Chicago, Illinois, USA.

References

1Rowe-Jones, JM, George, CD, Moore-Gillon, V, Grundy, A. Balloon dilatation of the pharynx. Clin Otolaryngol 1993;18:102–7CrossRefGoogle ScholarPubMed
2Jung, TT, Adams, GL. Dysphagia in laryngectomized patients. Otolaryngol Head Neck Surg 1980;88:25–33CrossRefGoogle ScholarPubMed
3Balfe, DM, Koehler, RE, Setzen, M, Weyman, PJ, Baron, RL, Ogura, JH. Barium examination of the esophagus after total laryngectomy. Radiology 1982;143:501–8CrossRefGoogle ScholarPubMed
4Starck, E, Paolucci, V, Herzer, M, Crummy, AB. Esophageal stenosis: treatment with balloon catheters. Radiology 1984;153:637–40CrossRefGoogle ScholarPubMed
5Saeed, ZA, Winchester, CB, Ferro, PS, Michaletz, PA, Schwartz, JT, Graham, DY. Prospective randomized comparison of polyvinyl bougies and through-the-scope balloons for dilation of peptic strictures of the esophagus. Gastrointest Endosc 1995;41:189–95CrossRefGoogle ScholarPubMed
6Hernandez, LV, Jacobson, JW, Harris, MS. Comparison among the perforation rates of Maloney, balloon, and Savary dilation of esophageal strictures. Gastrointest Endosc 2000;51:460–2CrossRefGoogle ScholarPubMed
7McLean, GK, LeVeen, RF. Sheer stress in the performance of esophageal dilation: comparison of balloon dilation and bouginage. Radiology 1989;172:983–6CrossRefGoogle Scholar
8Whitworth, PW, Richardson, RL, Larson, GM. Balloon dilatation of anastomotic strictures. Arch Surg 1988;123:759–62CrossRefGoogle ScholarPubMed
9Grundy, A. The radiological management of gastrointestinal strictures and other, obstructive lesions. Baillieres Clin Gastroenterol 1992;6:319–40CrossRefGoogle ScholarPubMed
10Sampson, S, Grundy, A. The radiological management of post-surgical strictures of the upper gastrointestinal tract. Eur Radiol 1990;2:117–20Google Scholar
11Grundy, A, Mills, P, Cawthorne, SJ. Balloon dilatation of upper gastrointestinal anastomoses. J Intervent Radiol 1990;1:7–12Google Scholar
12Lew, RJ, Shah, JN, Chalian, A, Weber, RS, Williams, NN, Kochman, ML. Technique of endoscopic retrograde puncture and dilatation of total esophageal stenosis in patients with radiation-induced strictures. Head Neck 2004;26:179–83CrossRefGoogle ScholarPubMed
13Steele, NP, Tokayer, A, Smith, RV. Retrograde endoscopic balloon dilation of chemotherapy- and radiation-induced esophageal stenosis under direct visualization. Am J Otolaryngol 2007;28:98–102CrossRefGoogle ScholarPubMed
14Vaghela, HM, Moir, AA. Hydrostatic balloon dilatation of pharyngeal stricture under local anaesthetic. J Laryngol Otol 2006;120:56–8CrossRefGoogle ScholarPubMed
15Thornton, MA, Conlon, BJ, Timon, C. How we did it: neopharyngeal stricture management with the nitinol stent in the laryngectomized patient: our disappointing results. Clin Otolaryngol 2005;30:369–71CrossRefGoogle ScholarPubMed
16Bacon, CK, Hendrix, RA. Open tube versus flexible esophagoscopy in adult head and neck endoscopy. Ann Otol Rhinol Laryngol 1992;101:147–55CrossRefGoogle ScholarPubMed
17Dawson, J, Cockel, R. Oesophageal perforation at fibreoptic gastroscopy. Br Med J (Clin Res Ed) 1981;283:987CrossRefGoogle ScholarPubMed
18Tulman, AB, Boyce, HW. Complications of esophageal dilation and guidelines for their prevention. Gastrointest Endosc 1981;27:229–34CrossRefGoogle ScholarPubMed
19McLean, GK, Cooper, GS, Hartz, WH, Burke, DR, Meranze, SG. Radiologically guided balloon dilation of gastrointestinal strictures. Radiology 1987;165:35–43CrossRefGoogle ScholarPubMed
20Maynar, M, Guerra, C, Reyes, R, Mayor, J, Garcia, J, Fascal, P et al. Esophageal strictures: balloon dilation. Radiology 1988;167:703–6CrossRefGoogle ScholarPubMed