Endoscopic balloon dilatation for pharyngo‐upper esophageal stricture after treatment of head and neck cancer

Maejima, Ryuhei; Iijima, Katsunori; Koike, Tomoyuki; Ara, Nobuyuki; Uno, Kaname; Hatta, Waku; Ogawa, Takenori; Watanabe, Ken Ichi; Katori, Yukio; Shimosegawa, Tooru

doi:10.1111/den.12345

Cited by 14 publications

(20 citation statements)

References 24 publications

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“…The included studies are summarized in Table . All studies were retrospective, and most reported outcomes of standard anterograde dilations using bougie or balloon dilators with or without guidewires.…”

Section: Resultsmentioning

confidence: 99%

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Esophageal dilation in head and neck cancer patients: A systematic review and meta‐analysis

et al. 2017

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Objective: To characterize the safety profile and effectiveness of esophageal dilation in head and neck cancer patients. Methods: A systematic review was undertaken for articles reporting outcomes of esophageal dilation in head and neck cancer patients. The Medline, Scopus, Web of Science, and Cochrane databases were searched in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Complications related to esophageal dilation in head and neck cancer patients was the primary outcome of interest. Success rates, demographic data, cancer staging, and treatment data were assessed secondarily. Statistical analyses included both qualitative and quantitative assessments. A limited metaanalysis and pooling of the data was performed using a random effects model.Results: Of the collective 8,243 initial candidate articles, 15 retrospective studies containing data for a collective 449 patients were ultimately included in the analysis. There was significant heterogeneity in the outcomes data. With an overall complication rate of 10.6% (95% confidence interval [CI]: 4.1%,17%) and a pooled success rate of 72.9% (95% CI: 65.7%,80.1%) per patient, the articles generally supported the use of dilation.Conclusion: Head and neck cancer patients experience a higher rate of complications following dilation compared to patients with other causes of benign stricture. Esophageal dilation is effective in improving dysphagia, but these benefits are often transient and thus necessitate repeat interventions.

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Section: Resultsmentioning

confidence: 99%

“…The average patient age was 60 (range 21–89) years, and there was a near 3:1 male predominance (232:87, 73%:27%) . Cancer staging and treatment data were reported variably (Fig.…”

Section: Resultsmentioning

confidence: 99%

Esophageal dilation in head and neck cancer patients: A systematic review and meta‐analysis

et al. 2017

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“…BD is a common procedure used to treat CPD and pharyngo-upper esophageal strictures in dysphagia patients [2,6,10,14,15]. There have not been any studies investigated the effectiveness of BD in dysphagia management from the perspective of swallow physiology changes.…”

Section: Discussionmentioning

confidence: 99%

“…Several methods have been used to treat Cricopharyngeal Muscle Achalasia (CMA), such as rigid dilators [12] or Botox injection planning [13], but as one of more convenient, less invasive methods, Balloon Dilatation (BD) has been used in more studies to treat cricopharyngeal dysfunction and pharyngo-upper esophageal strictures [2,6,10,[14][15][16]. It has been shown to improve UES relaxation and pharyngeal contraction amplitudes [6,14,15].…”

Section: Introductionmentioning

confidence: 99%

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The Swallow Physiology Change of Balloon Dilatation on Pharyngeal Dysphagia

Ding¹

2017

OHNS

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ObjectiveTo evaluate the effect of balloon dilatation in treating pyriform sinus residue caused by various swallow physiology changes from different medical diagnoses. Study designMedical records of 12 in-patients with moderate to severe pyriform sinus residue were retrospectively reviewed. MethodsAll patients were examined with fiberoptic endoscopic evaluation of swallowing and video fluoroscopic swallowing assessment. The diagnoses of the 12 patients included infarction, nasopharyngeal carcinoma post-radiation, oral cancer post partial glossectomy, and motor neuron disease. All 12 patients underwent balloon dilatation.Each session lasted 30 minutes, with eight dilatations per session, three sessions per week for two weeks. ResultsThere was significant reduction in pharyngeal residue pre-versus post-balloon dilatation (p=0.002). There were also significant improvements in cricopharyngeal muscle achalasia (p=0.004) and weak pharyngeal contraction (p=0.008) pre-versus post-treatment. Eight out of the 12 patients made significant progress toward oral feeding (66.67%). ConclusionOur study found cricopharyngeal muscle achalasia and weak pharyngeal contraction were closely related to pyriform sinus residue in pharyngeal dysphagia. Balloon dilatation eliminated cricopharyngeal muscle achalasia and weak pharyngeal contraction and significantly reduced pyriform sinus residue in 8 of the 12 patients. Balloon dilatation seems to have no effect on the reduction of pyriform sinus residue when the cause was either from discoordination of swallowing subsystems in the case of infarction of the left pontocerebellar trigone or loss of large bulk of tongue tissue in the case of cancer treatment.

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Safety of a Novel Upper Esophageal Sphincter Balloon Dilator

Wandell,

Swartwood,

Brar

et al. 2024

The Laryngoscope

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ObjectiveThe shape of esophageal dilators has not changed in over 350 years. Clinical and animal research suggests that the upper esophageal sphincter (UES) is not round but approximates a kidney shape and that cylindrical dilators may be suboptimal. The Infinity UES Dilation System has been developed specifically for the anatomic configuration of the UES. This study evaluates the safety of the UES‐specific Infinity Dilation System.MethodsAll patients undergoing dilation of the UES between January 1, 2022 and September 1, 2023 were included. Demographics, procedure indication, dilator type, minor adverse events, and major complications were abstracted. Minor adverse events, complications, and maximum dilation dimension (mm) were compared between groups.ResultsA total of 477 patients were included. Eight hundred and seventy‐three total UES dilations were performed. The primary indications for UES dilation were cricopharyngeus muscle dysfunction (43%) and stenosis from radiation toxicity (40%). Twenty‐three percent (202/873) of dilations were performed with an Infinity balloon, 31% (270/873) were performed using two conventional balloons placed side by side, and 46% (401/873) were performed with one singleton conventional balloon. The average maximum dilation dimension was 33 (±4.7) mm for Infinity balloons, 32 (±3.8) mm for two side‐by‐side balloons, and 18 (±3.4) mm for singleton balloons. There were three major complications with conventional balloons and none with Infinity balloons. There were no significant differences in minor adverse events between groups.ConclusionsA UES‐specific esophageal dilator provides a greater maximum dilation dimension and appears to be at least as safe as dilation with a single cylindrical balloon designed to dilate the esophagus.Level of EvidenceLevel 3 Laryngoscope, 2024

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Endoscopic balloon dilatation for pharyngo‐upper esophageal stricture after treatment of head and neck cancer

Cited by 14 publications

References 24 publications

Esophageal dilation in head and neck cancer patients: A systematic review and meta‐analysis

Esophageal dilation in head and neck cancer patients: A systematic review and meta‐analysis

The Swallow Physiology Change of Balloon Dilatation on Pharyngeal Dysphagia

Safety of a Novel Upper Esophageal Sphincter Balloon Dilator

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