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
