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. 2022 Feb;37(1):93-98.
doi: 10.1007/s00455-021-10253-z. Epub 2021 Mar 10.

Feasibility and Safety of Office-Based Transnasal Balloon Dilation for Neopharyngeal and Proximal Esophageal Strictures in Patients with a History of Head and Neck Carcinoma

Anouk S Schimberg  1 , David J Wellenstein  2 , Henrieke W Schutte  2 , J Honings  2 , Henri A M Marres  2 , Robert P Takes  2 , Guido B van den Broek  2
Affiliations

Feasibility and Safety of Office-Based Transnasal Balloon Dilation for Neopharyngeal and Proximal Esophageal Strictures in Patients with a History of Head and Neck Carcinoma

Anouk S Schimberg et al. Dysphagia. 2022 Feb.

Abstract

The aim of this study was to assess feasibility and safety of office-based transnasal balloon dilation of neopharyngeal and proximal esophageal strictures in patients with a history of head and neck carcinoma. The secondary objective was to explore its effectiveness. This prospective case series included patients previously treated for head and neck carcinoma with neopharyngeal or proximal esophageal strictures who underwent transnasal balloon dilation under topical anesthesia. The target dilation diameter was 15 mm; if necessary dilation procedures were repeated every 2-4 weeks until this target was reached. Completion rates, adverse events, and patient experiences measured by VAS scores (0 = no complaints - 10 = unbearable complaints), dysphagia scores based on food consistency (0 = no dysphagia - 5 = unable to swallow liquids/saliva), and self-reported changes in swallowing symptoms were recorded. Follow-up was 2 months. Twenty-six procedures were performed in 12 patients, with a completion rate of 92%. One minor complication occurred, i.e. an infection of the dilation site. Tolerance of the procedure was good (median VAS = 2). The dysphagia score improved after a mean of 2.2 procedures per patient, however not significantly. Eight patients reported improvement in dysphagia, of whom 3 had recurrence of dysphagia within 1 month post-treatment. Office-based transnasal balloon dilation is a feasible and safe in-office procedure which is well-tolerated by patients. The dilations can improve dysphagia, although effects might be transient.

Keywords: Esophageal strictures; Head and neck carcinoma; Office-based; Topical anesthesia; Transnasal balloon dilatation.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
VAS scores on tolerance of the dilation procedure. Legend: Visual analogue scale (VAS): 0 = no complaints, 10 = unbearable complaints; ○ = outlier, value more between 1.5 – 3 times the Inter Quartile Range. * = extreme outlier, value more than 3 times the Inter Quartile Range
Fig. 2
Fig. 2
Flow chart of patient-reported treatment outcomes
See this image and copyright information in PMC

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References

    1. Wang JJ, Goldsmith TA, Holman AS, Cianchetti M, Chan AW. Pharyngoesophageal stricture after treatment for head and neck cancer. Head Neck. 2012;34(7):967–973. doi: 10.1002/hed.21842. - DOI - PubMed
    1. Sweeny L, Golden JB, White HN, Magnuson JS, Carroll WR, Rosenthal EL. Incidence and outcomes of stricture formation postlaryngectomy. Otolaryngol Head Neck Surg. 2012;146(3):395–402. doi: 10.1177/0194599811430911. - DOI - PMC - PubMed
    1. Stoddard CJ, Simms JM. Dilatation of benign oesophageal strictures in the outpatient department. Br J Surg. 1984;71(10):752–753. doi: 10.1002/bjs.1800711005. - DOI - PubMed
    1. Qin Y, Sunjaya DB, Myburgh S, Sawas T, Katzka DA, Alexander JA, Halland M. Outcomes of oesophageal self-dilation for patients with refractory benign oesophageal strictures. Aliment Pharmacol Ther. 2018;48(1):87–94. doi: 10.1111/apt.14807. - DOI - PubMed
    1. Sinha UK, Swanson MS, Villegas BC, Ouyoung LM, Kokot N. Outcomes of Self-Esophageal Dilation for Head and Neck Cancer Patients. Am J Speech Lang Pathol. 2019;28(3):1060–1066. doi: 10.1044/2019_ajslp-18-0190. - DOI - PubMed

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