Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-28T02:57:10.340Z Has data issue: false hasContentIssue false
  • English
  • Français

Radiological balloon dilatation of post-treatment benign pharyngeal strictures

Published online by Cambridge University Press:  16 July 2009

L R Williams ,
D Kasir ,
S Penny ,
J J Homer  and
H-U Laasch
L R Williams*
Affiliation:
Department of Radiology, The Christie NHS Foundation Trust, Manchester, UK
D Kasir
Affiliation:
Department of Radiology, The Christie NHS Foundation Trust, Manchester, UK
S Penny
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Manchester Royal Infirmary, Manchester, UK
J J Homer
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Manchester Royal Infirmary, Manchester, UK
H-U Laasch
Affiliation:
Department of Radiology, The Christie NHS Foundation Trust, Manchester, UK
*
Address for correspondence: Dr Luke Williams, Consultant Radiologist, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK. Fax: 0161 206 5860 E-mail: luke.williams@srft.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Aims:

To assess the technical success, clinical outcomes and complications of radiologically guided balloon dilatation of benign strictures developing after treatment for head and neck cancer.

Materials and methods:

Forty-six balloon dilatations were performed in 20 patients. All dilatations were performed over a guidewire.

Results:

Technical success was 100 per cent. Fifteen of the 20 patients demonstrated clinical improvement in dysphagia scores. Improvement in dysphagia was temporary in all patients (median 102 days), with multiple dilatations usually required (total dilatations ranged from one to seven). Immediate complications were encountered in six of the 46 (13 per cent) dilatations and were all minor. Late complications occurred after two procedures (4 per cent): localised perforation (later complicated by secondary infection) and recurrence of a previous, small, pharyngo-cutaneous fistula.

Conclusion:

Radiologically guided balloon dilatation is straightforward to perform and is well tolerated, but there is a small risk of perforation. Relief of symptoms is likely to be temporary, requiring multiple subsequent dilatations. A minority of patients will obtain no symptomatic relief.

Keywords

Balloon DilatationPharynx
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 11 , November 2009 , pp. 1229 - 1232
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1de Casso, C, Slevin, NJ, Homer, JJ. The impact of radiotherapy on swallowing and speech in patients who undergo total laryngectomy. Otolaryngol Head Neck Surg 2008;139:792–7Google Scholar
2Starmer, HM, Tippett, DC, Webster, KT. Effects of laryngeal cancer on voice and swallowing. Otolaryngol Clin North Am 2008;41:793–818, viiCrossRefGoogle ScholarPubMed
3Nguyen, NP, Moltz, CC, Frank, C, Vos, P, Smith, HJ, Karlsson, U et al. Dysphagia following chemoradiation for locally advanced head and neck cancer. Ann Oncol 2004;15:383–8CrossRefGoogle ScholarPubMed
4McLean, GK, LeVeen, RF. Shear stress in the performance of esophageal dilation: comparison of balloon dilation and bougienage. Radiology 1989;172:983–6Google Scholar
5Rowe-Jones, JM, George, CD, Moore-Gillon, V, Grundy, A. Balloon dilatation of the pharynx. Clin Otolaryngol Allied Sci 1993;18:102–7CrossRefGoogle ScholarPubMed
6Bell, JK, Laasch, HU, Wilbraham, L, England, RE, Morris, JA, Martin, DF. Bispectral index monitoring for conscious sedation in intervention: better, safer, faster. Clin Radiol 2004;59:1106–13CrossRefGoogle ScholarPubMed
7Mellow, MH, Pinkas, H. Endoscopic laser therapy for malignancies affecting the esophagus and gastroesophageal junction. Analysis of technical and functional efficacy. Arch Intern Med 1985;145:1443–6CrossRefGoogle ScholarPubMed
8Piotet, E, Escher, A, Monnier, P. Esophageal and pharyngeal strictures: report on 1,862 endoscopic dilatations using the Savary-Gilliard technique. Eur Arch Otorhinolaryngol 2008;265:357–64CrossRefGoogle Scholar
9Ahlawat, SK, Al-Kawas, FH. Endoscopic management of upper esophageal strictures after treatment of head and neck malignancy. Gastrointest Endoscopy 2008;68:19–24Google Scholar
10Cox, JG, Winter, RK, Maslin, SC, Dakkak, M, Jones, R, Buckton, GK et al. Balloon or bougie for dilatation of benign esophageal stricture? Dig Dis Sci 1994;39:776–81CrossRefGoogle ScholarPubMed
11Scolapio, JS, Pasha, TM, Gostout, CJ, Mahoney, DW, Zinsmeister, AR, Ott, BJ et al. A randomized prospective study comparing rigid to balloon dilators for benign esophageal strictures and rings. Gastrointest Endosc 1999;50:13–17CrossRefGoogle ScholarPubMed
12Shemesh, E, Czerniak, A. Comparison between Savary-Gilliard and balloon dilatation of benign esophageal strictures. World J Surg 1990;14:518–21, 21–2CrossRefGoogle ScholarPubMed
13Thornton, 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