Dilation of proximal esophageal strictures following therapy for head and neck cancer: Experience with savary gilliard dilators

• Published in: Journal of surgical oncology Vol. 63; no. 3; pp. 187 - 190
• Main Authors: Dhir, Vinay, Vege, Santhi Swaroop, Mohandas, K. M., Desai, Devendra C.
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.11.1996; Wiley-Liss
• Subjects: Adult; Aged; Biological and medical sciences; Constriction, Pathologic - etiology; Constriction, Pathologic - therapy; Deglutition Disorders - etiology; Deglutition Disorders - therapy; Dilatation - instrumentation; Diseases of the upper aerodigestive tract; dysphagia; endoscopy; Ent and stomatology; Esophagus - pathology; Esophagus - radiation effects; Female; Follow-Up Studies; Head and Neck Neoplasms - radiotherapy; Head and Neck Neoplasms - surgery; Head and Neck Neoplasms - therapy; Humans; hypopharyngeal cancer; Male; Medical sciences; Middle Aged; Radiotherapy, Adjuvant; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Treatment Outcome; Human; Postoperative; Esophageal disease; Instrumentation therapy; Stenosis; Instrumental dilatation; Malignant tumor; Radiotherapy; Esophagus; Dilatator; Treatment; Surgery; Head and neck; Digestive diseases; ENT disease; Complication; Dysphagia; Technical equipment; Tumorectomy
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/(SICI)1096-9098(199611)63:3<187::AID-JSO10>3.0.CO;2-2

Background There is little information on dilation of proximal strictures following surgical and/or radiation therapy for head and neck cancer. We studied the feasibility and efficacy of dilating proximal strictures following therapy for head and neck cancer using Savary Gilliard dilators. Methods Twenty‐one consecutive patients with proximal strictures resulting from surgery and/or radiation therapy of head and neck cancer were studied. Savary Gilliard dilation was performed using the standard and a modified method. Dysphagia was graded before and after dilation using a 5‐point scale. Results Technical success, dysphagia relief, complications, and duration of relief were noted. Technical success was achieved in 20 (95%) patients. Adequate dysphagia relief was obtained in 15/20 (75%) patients, which lasted for 4–36 weeks (median 14 weeks). There were no perforations, bleeding, or deaths. Four patients required repeat dilation after a median interval of 12 weeks. Conclusions Savary Gilliard dilation is a safe and effective method for dilating strictures caused by therapy for head and neck cancer. © 1996 Wiley‐Liss, Inc.