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Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review

BACKGROUND: Endoscopic dilation of postlaryngectomy strictures (PLS) is safe and effective; however, PLS are often refractory and require serial dilations. Long-term outcomes of dilation in patients with refractory PLS are not well reported. MATERIALS AND METHODS: Seven patients with dysphagia and r...

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Autores principales: Stoner, Patrick L., Fullerton, Amy L., Freeman, Alyssa M., Chheda, Neil N., Estores, David S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6558613/
https://www.ncbi.nlm.nih.gov/pubmed/31275367
http://dx.doi.org/10.1155/2019/8905615
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author Stoner, Patrick L.
Fullerton, Amy L.
Freeman, Alyssa M.
Chheda, Neil N.
Estores, David S.
author_facet Stoner, Patrick L.
Fullerton, Amy L.
Freeman, Alyssa M.
Chheda, Neil N.
Estores, David S.
author_sort Stoner, Patrick L.
collection PubMed
description BACKGROUND: Endoscopic dilation of postlaryngectomy strictures (PLS) is safe and effective; however, PLS are often refractory and require serial dilations. Long-term outcomes of dilation in patients with refractory PLS are not well reported. MATERIALS AND METHODS: Seven patients with dysphagia and refractory PLS underwent serial endoscopic dilation therapy during a 4.5-year period. Dilation characteristics, technical success, clinical success, and diet advancement (as assessed by Diet/GT scale) were measured. Results. All strictures were complex, and there were no reported complications. The median number of dilations per patient was 12 (range 7 to 48). The average interval in between dilations was six weeks. Technical success was achieved in 6/7 patients, and clinical success was achieved in 2/7 patients. 6/7 patients had advancements in Diet/GT scores. CONCLUSIONS: Dilation of refractory PLS is safe and effective and frequently requires the use of a retrograde approach, fluoroscopic guidance, and/or lumen patency strings. Serial dilations are required to maintain luminal patency, relieve dysphagia, and advance oral diet. The definition of clinical success of dilation in these patients should avoid the use of a specific time interval between dilations to characterize success.
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spelling pubmed-65586132019-07-02 Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review Stoner, Patrick L. Fullerton, Amy L. Freeman, Alyssa M. Chheda, Neil N. Estores, David S. Gastroenterol Res Pract Clinical Study BACKGROUND: Endoscopic dilation of postlaryngectomy strictures (PLS) is safe and effective; however, PLS are often refractory and require serial dilations. Long-term outcomes of dilation in patients with refractory PLS are not well reported. MATERIALS AND METHODS: Seven patients with dysphagia and refractory PLS underwent serial endoscopic dilation therapy during a 4.5-year period. Dilation characteristics, technical success, clinical success, and diet advancement (as assessed by Diet/GT scale) were measured. Results. All strictures were complex, and there were no reported complications. The median number of dilations per patient was 12 (range 7 to 48). The average interval in between dilations was six weeks. Technical success was achieved in 6/7 patients, and clinical success was achieved in 2/7 patients. 6/7 patients had advancements in Diet/GT scores. CONCLUSIONS: Dilation of refractory PLS is safe and effective and frequently requires the use of a retrograde approach, fluoroscopic guidance, and/or lumen patency strings. Serial dilations are required to maintain luminal patency, relieve dysphagia, and advance oral diet. The definition of clinical success of dilation in these patients should avoid the use of a specific time interval between dilations to characterize success. Hindawi 2019-05-28 /pmc/articles/PMC6558613/ /pubmed/31275367 http://dx.doi.org/10.1155/2019/8905615 Text en Copyright © 2019 Patrick L. Stoner et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Stoner, Patrick L.
Fullerton, Amy L.
Freeman, Alyssa M.
Chheda, Neil N.
Estores, David S.
Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review
title Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review
title_full Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review
title_fullStr Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review
title_full_unstemmed Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review
title_short Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review
title_sort endoscopic dilation of refractory postlaryngectomy strictures: a case series and literature review
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6558613/
https://www.ncbi.nlm.nih.gov/pubmed/31275367
http://dx.doi.org/10.1155/2019/8905615
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