Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review
Background. Endoscopic dilation of postlaryngectomy strictures (PLS) is safe and effective; however, PLS are often refractory and require serial dilations. Long-term outcomes of dilation in patients with refractory PLS are not well reported. Materials and Methods. Seven patients with dysphagia and r...
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Wiley
2019-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/8905615 |
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| author | Patrick L. Stoner Amy L. Fullerton Alyssa M. Freeman Neil N. Chheda David S. Estores |
| author_facet | Patrick L. Stoner Amy L. Fullerton Alyssa M. Freeman Neil N. Chheda David S. Estores |
| author_sort | Patrick L. Stoner |
| collection | DOAJ |
| description | Background. Endoscopic dilation of postlaryngectomy strictures (PLS) is safe and effective; however, PLS are often refractory and require serial dilations. Long-term outcomes of dilation in patients with refractory PLS are not well reported. Materials and Methods. Seven patients with dysphagia and refractory PLS underwent serial endoscopic dilation therapy during a 4.5-year period. Dilation characteristics, technical success, clinical success, and diet advancement (as assessed by Diet/GT scale) were measured. Results. All strictures were complex, and there were no reported complications. The median number of dilations per patient was 12 (range 7 to 48). The average interval in between dilations was six weeks. Technical success was achieved in 6/7 patients, and clinical success was achieved in 2/7 patients. 6/7 patients had advancements in Diet/GT scores. Conclusions. Dilation of refractory PLS is safe and effective and frequently requires the use of a retrograde approach, fluoroscopic guidance, and/or lumen patency strings. Serial dilations are required to maintain luminal patency, relieve dysphagia, and advance oral diet. The definition of clinical success of dilation in these patients should avoid the use of a specific time interval between dilations to characterize success. |
| format | Article |
| id | doaj-art-e0ee73c92fec4a9aa12b0ef5cc9ab0a2 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-e0ee73c92fec4a9aa12b0ef5cc9ab0a22025-02-03T05:52:14ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/89056158905615Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature ReviewPatrick L. Stoner0Amy L. Fullerton1Alyssa M. Freeman2Neil N. Chheda3David S. Estores4Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USASpeech, Language, and Hearing Sciences, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USASpeech, Language, and Hearing Sciences, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USAOtolaryngology, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USAGastroenterology, Hepatology & Nutrition, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USABackground. Endoscopic dilation of postlaryngectomy strictures (PLS) is safe and effective; however, PLS are often refractory and require serial dilations. Long-term outcomes of dilation in patients with refractory PLS are not well reported. Materials and Methods. Seven patients with dysphagia and refractory PLS underwent serial endoscopic dilation therapy during a 4.5-year period. Dilation characteristics, technical success, clinical success, and diet advancement (as assessed by Diet/GT scale) were measured. Results. All strictures were complex, and there were no reported complications. The median number of dilations per patient was 12 (range 7 to 48). The average interval in between dilations was six weeks. Technical success was achieved in 6/7 patients, and clinical success was achieved in 2/7 patients. 6/7 patients had advancements in Diet/GT scores. Conclusions. Dilation of refractory PLS is safe and effective and frequently requires the use of a retrograde approach, fluoroscopic guidance, and/or lumen patency strings. Serial dilations are required to maintain luminal patency, relieve dysphagia, and advance oral diet. The definition of clinical success of dilation in these patients should avoid the use of a specific time interval between dilations to characterize success.http://dx.doi.org/10.1155/2019/8905615 |
| spellingShingle | Patrick L. Stoner Amy L. Fullerton Alyssa M. Freeman Neil N. Chheda David S. Estores Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review Gastroenterology Research and Practice |
| title | Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review |
| title_full | Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review |
| title_fullStr | Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review |
| title_full_unstemmed | Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review |
| title_short | Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review |
| title_sort | endoscopic dilation of refractory postlaryngectomy strictures a case series and literature review |
| url | http://dx.doi.org/10.1155/2019/8905615 |
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