Radiologically guided balloon dilatation of neopharyngeal strictures following total laryngectomy and pharyngolaryngectomy: 21 years’ experience

OBJECTIVE: To assess the efficacy of radiologically guided balloon dilatation for the treatment of dysphagia secondary to neopharyngeal strictures in patients who have undergone laryngectomy. STUDY DESIGN: Retrospective case series. SUBJECTS AND METHODS: Twenty consecutive patients with pharyngeal stricture and dysphagia following total laryngectomy or pharyngolaryngectomy. Patients underwent balloon dilatation of the stricture under radiological guidance. The main outcome measure was maintenance of swallowing. RESULTS: Five patients gained relief of their dysphagia with one balloon dilatation only. Nine patients required more than one dilatation to maintain swallowing. Two patients had balloon dilatation procedures and stent insertion for palliative relief of dysphagia from known recurrent malignant disease. Three patients failed to maintain swallowing with repeat dilatations. No patients suffered any significant complications such as perforation. CONCLUSIONS: Radiologically guided balloon dilatation is minimally invasive and safe. It is well tolerated. It may be repeated frequently, and can successfully relieve pharyngeal strictures in patients who have undergone total laryngectomy or pharyngolaryngectomy.