title: Total neopharyngeal stenosis following pharyngolaryngo-oesophagectomy with gastric interposition: Successful recanalisation using a transcervical radiologically guided technique.
abstract: BACKGROUND
  Pharyngo-oesophageal stricturing is common following treatment of head and neck cancers. Absolute dysphagia secondary to total stenosis, although rare, is particularly debilitating and presents a significant therapeutic challenge. We present a strategy for managing total neopharyngeal stenosis following pharyngolaryngo-oesophagectomy (PLOG).
  
  
  METHODS
  A 71-year-old female developed total neopharyngeal stenosis following PLOG with gastric interposition for squamous cell carcinoma of the proximal cervical oesophagus/post-cricoid. A transcervical, percutaneous, radiologically guided procedure was performed to restore lumenal patency, which enabled resumption of oral feeding.
  
  
  CONCLUSIONS
  Established treatments for pharyngo-oesophageal strictures are frequently limited by complications in patients with complex strictures or total stenoses. Whilst several interventions have been described, recent interest has focussed on combined antegrade/retrograde endoscopic procedures dilating a pre-existing gastrostomy site for access. This was not possible in our patient due to the surgically altered anatomy which posed a unique therapeutic challenge.
  
  
  CONCLUSIONS
  This is the first reported percutaneous, transcervical, radiologically guided technique to treat neopharyngeal stenosis following PLOG. It demonstrates a novel and efficacious approach which may be considered in the management of this rare but significant complication.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, St. John's Hospital, Howden Road West, Livingston, West Lothian EH54 6PP, UK.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Wilkie
authors.forename: Iain F
authors.initials: IF
authors.lastname: Hathorn
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Evans
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