Videofluoroscopy-guided balloon dilatation for treatment of severe pharyngeal dysphagia

Abstract

Balloon dilatation is a widely accepted technique in the management of esophageal and other types of gastrointestinal strictures, but it is rarely used for the treatment of pharyngeal dysphagia. Therefore, the aim of our prospective study was to evaluate the use of videofluoroscopy-guided balloon dilatation (VGBD) for the treatment of severe pharyngeal dysphagia. The study included 32 stroke patients who had been diagnosed with oral and/or pharyngeal dysphagia. All patients underwent dilatation of the esophageal inlet using a balloon catheter under videofluoroscopic guidance during one or more sessions. Following esophageal dilatation, manual feeding was provided twice weekly. VGBD was effective in 10 out of 32 patients; however, the remaining 22 patients were unable to attempt oral food consumption because aspiration was not completely resolved on videofluoroscopy. According to this case series, VGBD may provide treatment for patients with severe pharyngeal dysphagia, who have not consumed food orally for a long period of time.

Figure 1. a–c.

Videofluorographic swallow study images of an 80-year-old woman with severe pharyngeal dysphagia. Videofluorography (a) shows aspiration before the first videofluoroscopic-guided balloon dilatation (arrows). Balloon is inflated using contrast media (arrowhead, b). Videofluorography (c) shows no aspiration after balloon expansion.

Figure 2. a–c.

Videofluorographic swallow study images of an 83-year-old man with severe pharyngeal dysphagia. Videofluorography (a) shows aspiration before the first videofluoroscopy-guided balloon dilatation (black arrows). Balloon is inflated using contrast media (arrowhead, b). Videofluorography (c) shows some aspiration after balloon expansion (white arrows).