title: Therapeutic options for management of pharyngoesophageal corrosive strictures.
abstract: BACKGROUND
  Pharyngoesophageal strictures due to corrosive injury raise difficult therapeutic problems due to the site of stricture, the possible association with laryngeal injury and the presence of downstream esophageal strictures. We present here our approach to management of 51 consecutive patients with pharyngoesophageal strictures seen over a 30-year period.
  
  
  METHODS
  Patients (51) with PES were managed by one of several options depending on the individual case, viz. dilatation alone, dilatation followed by esophagocoloplasty, dilatation after cervical esophagostomy with or without an esophagocoloplasty, pectoralis major or sternocleidomastoid myocutaneous flap inlays with or without esophagocoloplasty, pharyngocoloplasty with tracheostomy, and neck exploration followed by esophagocoloplasty if a lumen was found in the cervical esophagus.
  
  
  RESULTS
  The overall results were excellent with satisfactory swallowing restored in 45 out 51 patients (88.2%). There was one death and three incidences of complications, two patients with temporary cervical salivary fistula, and one patient in whom swallowing could not be restored because of lack of suitable conduit. The mean dysphagia score was improved from a pre-operative value of 3.6 to 1.5 post-operatively.
  
  
  CONCLUSIONS
  In conclusion, pharyngoesophageal strictures require considerable expertise in management, and one should be aware of various options for this purpose. The choice of procedure depends on site of stricture, time of presentation after the corrosive injury, relationship of the stricture to the laryngeal inlet, status of the larynx and the airway, length of the stricture, presence or absence of a lumen distal to the stricture in the cervical esophagus, and presence or absence of strictures further downstream. With proper treatment, mortality is negligible and morbidity minimal and is usually restricted to temporary salivary fistula.
authors.affiliation: Jawaharlal Institute of Postgraduate Medical Education and Research, IIA, Vairam Enclave, Pondicherry 605 006, India. n.ananthk@gmail.com
authors.forename: Nilakantan
authors.initials: N
authors.lastname: Ananthakrishnan
authors.forename: Vikram
authors.initials: V
authors.lastname: Kate
authors.forename: Govindaraju
authors.initials: G
authors.lastname: Parthasarathy
mesh_terms: D000293:Adolescent; D000328:Adult; D002057:Burns, Chemical / Q000150:complications*; D002424:Caustics / Q000633:toxicity*; D003251:Constriction, Pathologic; D003680:Deglutition Disorders / Q000628:therapy; D013505:Digestive System Surgical Procedures; D004106:Dilatation; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D010614:Pharynx / Q000000981:diagnostic imaging / Q000293:injuries*; D011859:Radiography; D013524:Surgical Flaps; D055815:Young Adult
chemical_list: D002424:Caustics