%0 Journal Article
%T Novel Therapeutic Strategy for Pharyngoesophageal Stricture following Total Laryngectomy
%A Dart A. Fox
%A Eric D. Blom
%A Ian J. Cook
%A Julia Maclean
%A Michal M. Szczesniak
%A Peter I. Wu
%J Otolaryngology¨CHead and Neck Surgery
%@ 1097-6817
%D 2019
%R 10.1177/0194599818815164
%X Current therapeutic strategies for pharyngoesophageal stricture, while effective in the short term, are protracted and costly in the longer term. Conceptually, if a stricture can be dilated with minimal tissue injuries, the rate of fibrosis and the resultant stricture recurrence could be reduced. We evaluated a prototype computer-controlled syringe pump device programmed to distend a commercially available balloon dilator at variable rate, asserting incremental lumen distension pressures tailored to the resistive force encountered within the stricture. We completed 17 graded dilatation procedures among 4 total laryngectomy patients. All patients had a short-term response (1 month), with a mean decrement (improvement) in Sydney Swallow Questionnaire score of 448 (total score range, 0-1700; normal <234). The overall procedural tolerability and safety were encouraging; the only complication was the displacement of the voice prosthesis during 1 dilatation. From a technical viewpoint, the main challenge was to maintain the balloon in position during dilatation
%K dysphagia
%K strictures
%K pharyngoesophageal junction
%K radiotherapy
%K laryngectomy
%K dilatation
%U https://journals.sagepub.com/doi/full/10.1177/0194599818815164