Dilation of proximal esophageal strictures following therapy for head and neck cancer: experience with Savary Gilliard dilators.
BACKGROUND
There is little information on dilation of proximal strictures following surgical and/or radiation therapy for head and neck cancer. We studied the feasibility and efficacy of dilating proximal strictures following therapy for head and neck cancer using Savary Gilliard dilators.


METHODS
Twenty-one consecutive patients with proximal strictures resulting from surgery and/or radiation therapy of head and neck cancer were studied. Savary Gilliard dilation was performed using the standard and a modified method. Dysphagia was graded before and after dilation using a 5-point scale.


RESULTS
Technical success, dysphagia relief, complications, and duration of relief were noted. Technical success was achieved in 20 (95%) patients. Adequate dysphagia relief was obtained in 15/20 (75%) patients, which lasted for 4-36 weeks (median 14 weeks). There were no perforations, bleeding, or deaths. Four patients required repeat dilation after a median interval of 12 weeks.


CONCLUSIONS
Savary Gilliard dilation is a safe and effective method for dilating strictures caused by therapy for head and neck cancer.
Dhir
V
V
Division of Medical Gastroenterology, Tata Memorial Hospital, Parel, Bombay, India.
Vege
S S
SS
Mohandas
K M
KM
Desai
D C
DC
D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D004106:Dilatation / Q000295:instrumentation*; D004947:Esophagus / Q000473:pathology* / Q000528:radiation effects; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome