Objective: To review experience, safety, and cost of office-based esophageal dilation in patients with history of head and neck cancer (HNCA).
Methods: The medical records of patients undergoing esophageal dilation in the office were retrospectively reviewed between August 2015 and May 2017. Patients were given nasal topical anesthesia. Next, a transnasal esophagoscopy (TNE) was performed. If the patient tolerated TNE, we proceeded with esophageal dilation using Seldinger technique with the CRE™ Boston Scientific (Boston Scientific Corp., Marlborough, MA) balloon system. Patients were discharged directly from the outpatient clinic.
Results: Forty-seven dilations were performed in 22 patients with an average of 2.1 dilations/patient (range 1-10, standard deviation [SD] ± 2.2). Seventeen patients (77%) were male. The average age was 67 years (range 35-78 years, SD ± 8.5). The most common primary site of cancer was oral cavity/oropharynx (n = 10), followed by larynx (n = 6). All patients (100%) had history of radiation treatment. Four patients were postlaryngectomy. The indication for esophageal dilation was esophageal stricture and progressive dysphagia. All dilations occurred in the proximal esophagus. There were no major complications. Three focal, superficial lacerations occurred. Two patients experienced mild, self-limited epistaxis. One dilation was poorly tolerated due to discomfort. One patient required pain medication postprocedure. Office-based esophageal dilation generated $15,000 less in health system charges compared to traditional operating room dilation on average per episode of care.
Conclusion: In patients with history of HNCA and radiation, office-based TNE with esophageal dilation appears safe, well-tolerated, and cost-effective. In a small cohort, the technique has low complication rate and is feasible in an otolaryngology outpatient office setting.
Level Of Evidence: 4. Laryngoscope, 128:2261-2267, 2018.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/lary.27121 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
ACG Clinical Guideline: Diagnosis and Management of Eosinophilic Esophagitis.
Am J Gastroenterol
January 2025
Kennth C. Griffin Esophageal Center, Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus. It is diagnosed in the setting of symptoms of esophageal dysfunction and an eosinophilic predominant infiltrate in the esophagus. The condition is rapidly increasing in incidence and prevalence and is commonly encountered in gastroenterology and allergy practices, emergency departments, and primary care settings.
View Article and Find Full Text PDFPersistent body-weight change on achalasia and peroral endoscopic myotomy: a multicenter cohort study.
J Gastroenterol
December 2024
Digestive Diseases Center, Showa University Koto-Toyosu Hospital, Tokyo, Japan.
Background: The distribution of body weight in patients with achalasia and after peroral endoscopic myotomy (POEM) has not been investigated. The role of body weight assessment after treatment remains unclear.
Methods: Using the multicenter achalasia cohort, the frequency of underweight (body mass index [BMI] < 18.
Twenty years of anastomotic stenosis combined with tracheocolonic fistula after colon replacement esophagectomy: a case report.
Front Oncol
December 2024
Lanshan District People's Hospital, Department of Thoracic Surgery, Linyi, Shandong, China.
Esophageal stricture is the most common and disabling complication of esophageal injury caused by ingestion of corrosive substances. In our case, the patient developed esophageal stenosis due to ingestion of strong alkaline substances and underwent colon replacement surgery after repeated failed dilation treatments. After surgery, anastomotic stenosis and tracheocolonic fistula occurred successively, and the entire diagnosis and treatment cycle of this disease lasted for more than 20 years.
View Article and Find Full Text PDFPre- and post-intervention oesophageal pressure topography metrics in the three subtypes of achalasia: A pilot study on Indian adults.
Med J Armed Forces India
December 2024
Consultant (Med & Gastroenterology), Command Hospital (Eastern Command), Kolkata, India.
Background: Achalasia is characterized by failure of relaxation of the lower oesophageal sphincter (LOS) and abnormal peristalsis during swallowing. The study aimed to observe the effects of intervention in three sub-types of achalasia and compare the intervention outcomes among the three sub-types.
Methods: Forty-one patients underwent Eckardt scoring for severity of achalasia, followed by high-resolution manometry (HRM).
Eosinophilic oesophagitis in adults: from symptoms to therapeutic options.
Intern Emerg Med
December 2024
Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.
Eosinophilic oesophagitis (EoE) is a chronic and progressive immune-mediated condition, typically affecting young atopic male adults and potentially leads to organ dysfunction and fibrosis. The clinical spectrum widely varies -from non-troublesome dysphagia to food impaction- and hence the rate of misdiagnosis and diagnostic delay are high, especially when presenting with minor symptoms, such as heartburn and acid regurgitation. There have been several major therapeutic breakthroughs for the management of EoE in recent years.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!