Patients requiring multiple dilations are at increased risk of persistent dysphagia long-term.

 

Following total laryngectomy (TL) or laryngopharyngectomy (TLP), patients may develop strictures that Head Neck require multiple dilations to treat. However, the risk factors associated with dysphagia refractory to a single dilation are unknown.

 Cortina et al from the Massachusetts Eye and Ear, Boston, studied the risk factors to requiring dilations after TL/TLP.  49 patients who underwent at least one stricture dilation after TL/TLP between March 2013 and March 2022 were evauated.  Thirty-five (71%) patients underwent multiple dilations. Pharyngocutaneous fistula, primary chemoradiation therapy, and a shorter time interval from TL/TLP to first dilation were independently associated with dysphagia requiring multiple dilations. Patients in the multiple dilations group had a higher rate of limited diet and G-tube dependence compared to patients in the single dilation group.

The authors concluded that shorter time interval to stricture formation is a prognostic indicator of the need for multiple dilations following TL/TLP. Patients requiring multiple dilations are at increased risk of persistent dysphagia long-term.

Endoscopic dilation balloon