Natalie Silver1, T J Gal. 1. Department of Otolaryngology, University of Kentucky, Lexington, Kentucky, USA.
Abstract
OBJECTIVE: Treatment of head and neck cancer with chemoradiation (CRT) can result in strictures of the cervical esophagus, often at the level of the cricopharyngeus. The objective of this study is to assess the feasibility of endoscopic CO2 laser cricopharyngeal myotomy for stricture ablation in the setting of prior CRT. METHODS: A retrospective review of patients who underwent endoscopic CO2 laser cricopharyngeal myotomy for dysphagia after radiation for squamous cell carcinoma of the head and neck (SCCHN). Pre- and postoperative barium swallow and swallowing assessment were performed before and after surgery. Outcomes and complication rates were examined. RESULTS: Endoscopic CO2 laser cricopharyngeal myotomy was performed in 10 patients with dysphagia secondary to cricopharyngeal stenosis/stricture, which developed following treatment for SCCHN with chemoradiation. All patients demonstrated radiographic improvement in stricture, with complete resolution of stricture in 9 of 10 patients. All patients noted improvement in dysphagia with 9 of 10 patients demonstrating significant advancement of diet by modified barium swallow. No complications were observed. CONCLUSION: Endoscopic CO2 cricopharyngeal myotomy can be performed safely in the setting of prior CRT, with significant improvement in swallowing in select patients. Indications and technical considerations will be discussed.
OBJECTIVE: Treatment of head and neck cancer with chemoradiation (CRT) can result in strictures of the cervical esophagus, often at the level of the cricopharyngeus. The objective of this study is to assess the feasibility of endoscopic CO2 laser cricopharyngeal myotomy for stricture ablation in the setting of prior CRT. METHODS: A retrospective review of patients who underwent endoscopic CO2 laser cricopharyngeal myotomy for dysphagia after radiation for squamous cell carcinoma of the head and neck (SCCHN). Pre- and postoperative barium swallow and swallowing assessment were performed before and after surgery. Outcomes and complication rates were examined. RESULTS: Endoscopic CO2 laser cricopharyngeal myotomy was performed in 10 patients with dysphagia secondary to cricopharyngeal stenosis/stricture, which developed following treatment for SCCHN with chemoradiation. All patients demonstrated radiographic improvement in stricture, with complete resolution of stricture in 9 of 10 patients. All patients noted improvement in dysphagia with 9 of 10 patients demonstrating significant advancement of diet by modified barium swallow. No complications were observed. CONCLUSION: Endoscopic CO2 cricopharyngeal myotomy can be performed safely in the setting of prior CRT, with significant improvement in swallowing in select patients. Indications and technical considerations will be discussed.
Authors: Laura W J Baijens; Margaret Walshe; Leena-Maija Aaltonen; Christoph Arens; Reinie Cordier; Patrick Cras; Lise Crevier-Buchman; Chris Curtis; Wojciech Golusinski; Roganie Govender; Jesper Grau Eriksen; Kevin Hansen; Kate Heathcote; Markus M Hess; Sefik Hosal; Jens Peter Klussmann; C René Leemans; Denise MacCarthy; Beatrice Manduchi; Jean-Paul Marie; Reza Nouraei; Claire Parkes; Christina Pflug; Walmari Pilz; Julie Regan; Nathalie Rommel; Antonio Schindler; Annemie M W J Schols; Renee Speyer; Giovanni Succo; Irene Wessel; Anna C H Willemsen; Taner Yilmaz; Pere Clavé Journal: Eur Arch Otorhinolaryngol Date: 2020-12-19 Impact factor: 2.503