Caustic ingestion can lead to oesophageal stenosis. We studied 251 patients, 205 of whom were children, in a sixteen-year period. Seventeen patients, of whom one was an adult, acquired deep burns in the oesophagus which had to be treated, to prevent the development of oesophageal strictures. These patients were treated with long-term stenting of the oesophagus with specially designed, silicone rubber stents, impregnated with silicone oil 20 cS, designed by one of us (R.N.P.B.) as the only treatment. Of all models, the twin-tube dilatator was the most satisfactory. No corticosteroids were administered. Only one patient developed a mild stenosis. It is therefore our opinion that, when life-saving operations are not indicated, twin-tube stenting of the oesophagus is helpful in treating caustic lesions of the oesophagus and will prevent stricture formation. Corticosteroids were not given in this series, and should be abandoned in the treatment of caustic lesions.

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SummaryENCOURAGED by reports of the treatment of laryngotracheal obstruction with nasotracheal intubation (N.T.I.), we began in 1965 to use this method in patients presenting such problems. At the outset we decided to use unsterilized and siliconized P.V.C. tubes in order to avoid toxicity and to provide ‘boundary lubrication’. Some preliminary experiments on these matters are presented.We found that by using this approach the range of indications for N.T.I, could be greatly extended. Forty-three out of forty-six patients, most of whom had chronic narrowings, were treated satisfactorily. The fact that eleven patients with obstructions caused by previous endotracheal intubation were cured by further intubation is noteworthy.

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