BACKGROUND: Permanent dysphagia occurring after laryngectomy or laryngopharyngectomy can usually be treated by periodic dilation. Occasionally, however, conservative treatment is insufficient, and patients require long-term tube feeding. We describe 4 cases with stricture after laryngopharyngectomy who underwent insertion of self-expandable plastic stents (SEPSs) across the stricture for treatment of dysphagia. OBJECTIVE: The aim of this study was to evaluate the role of SEPSs in postlaryngopharyngectomy strictures. DESIGN: An interventional study of management of 4 patients of dysphagia after laryngopharyngectomy with SEPSs. SETTING: Medical gastroenterology unit in a tertiary care hospital. PATIENTS: Four patients with dysphagia after laryngopharyngectomy. INTERVENTIONS: SEPS placement and removal after 3 months. MAIN OUTCOME MEASUREMENTS: Improvement in dysphagia. METHODS: Four patients with dysphagia after laryngopharyngectomy underwent dilation of stricture followed by SEPS placement for 3 months. RESULTS: Three patients had grade IV, and 1 grade III dysphagia. Endoscopy showed stricture at 10 to 14 cm from the incisors. Stricture was dilated up to 15 mm on 3 occasions, 2 weeks apart. A silicone Polyflex stent was placed across the stricture and removed after 3 months. No dysphagia recurred after 2 months. No significant complications were noted. LIMITATIONS: Small sample size. CONCLUSIONS: SEPSs dilate postlaryngopharyngectomy strictures and prevent restenosis even after removal. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
BACKGROUND: Permanent dysphagia occurring after laryngectomy or laryngopharyngectomy can usually be treated by periodic dilation. Occasionally, however, conservative treatment is insufficient, and patients require long-term tube feeding. We describe 4 cases with stricture after laryngopharyngectomy who underwent insertion of self-expandable plastic stents (SEPSs) across the stricture for treatment of dysphagia. OBJECTIVE: The aim of this study was to evaluate the role of SEPSs in postlaryngopharyngectomy strictures. DESIGN: An interventional study of management of 4 patients of dysphagia after laryngopharyngectomy with SEPSs. SETTING: Medical gastroenterology unit in a tertiary care hospital. PATIENTS: Four patients with dysphagia after laryngopharyngectomy. INTERVENTIONS:SEPS placement and removal after 3 months. MAIN OUTCOME MEASUREMENTS: Improvement in dysphagia. METHODS: Four patients with dysphagia after laryngopharyngectomy underwent dilation of stricture followed by SEPS placement for 3 months. RESULTS: Three patients had grade IV, and 1 grade III dysphagia. Endoscopy showed stricture at 10 to 14 cm from the incisors. Stricture was dilated up to 15 mm on 3 occasions, 2 weeks apart. A silicone Polyflex stent was placed across the stricture and removed after 3 months. No dysphagia recurred after 2 months. No significant complications were noted. LIMITATIONS: Small sample size. CONCLUSIONS: SEPSs dilate postlaryngopharyngectomy strictures and prevent restenosis even after removal. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.