High pharyngoesophageal strictures after laryngopharyngectomy can also be treated by self-expandable plastic stents

Background: Permanent dysphagia occurring after laryngectomy or laryngopharyngectomy can usually be treated by periodic dilation. Occasionally, however, conservative treatment is insufficient, and patients require long-term tube feeding. We describe 4 cases with stricture after laryngopharyngectomy who underwent insertion of self-expandable plastic stents (SEPSs) across the stricture for treatment of dysphagia. Objective: The aim of this study was to evaluate the role of SEPSs in postlaryngopharyngectomy strictures. Design: An interventional study of management of 4 patients of dysphagia after laryngopharyngectomy with SEPSs. Setting: Medical gastroenterology unit in a tertialy care hospital. Patients: Four patients with dysphagia after laryngopharyngectomy. Interventions: SEPS placement and removal after 3 months. Main Outcome Measurements: Improvement in dysphagia. Methods: Four patients with dysphagia after laryngopharyngectomy underwent dilation of stricture followed by SEPS placement for 3 months. Results: Three patients had grade IV, and 1 grade Ell dysphagia. Endoscopy showed stricture at 10 to 14 cm from the incisors. Stricture was dilated up to 15 mm on 3 occasions, 2 weeks apart. A silicone Polyflex stem was placed across the stricture and removed after 3 months. No dysphagia recurred after 2 months. No significant complications were noted. Limitations: Small sample size. Conclusions: SEPSs dilate postlaryngopharyngectomy strictures and prevent restenosis even after removal.