title: Salivary bypass tube placement in esophageal stricture: A technical note and report of three cases.
abstract: Hypopharyngeal and cervical esophageal strictures can be caused by advanced malignancies, ingestion of caustic materials, or can follow surgery or radiation therapy. They cause marked dysphagia and consequently patients need nasogastric or gastrostomy tube feeding, with a remarkable impact on quality of life. To restore oral feeding, the stenosis can be progressively dilated by using rubber bougies of increasing diameter, and a Montgomery®Salivary Bypass Tube can then be inserted to maintain the obtained calibre. However, while its flexibility makes it easy to tolerate, it has the drawback of making insertion difficult because the tube tends to bend. The aim of this paper is to present a possible solution to this problem. A Montgomery®Salivary Bypass Tube was distally sutured to a Cook Airway Exchange Catheter®to simplify its initial insertion through a laryngoscope and following replacements. The catheter was then easily removed leaving the bypass tube in the correct position. In our experience, this innovative approach proved effective in facilitating Montgomery®Salivary Bypass Tube insertion in three patients, without risks for the patient, additional operative time or increase in costs.
authors.affiliation: ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Integrata di Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Tirelli
authors.affiliation: ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Integrata di Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Baruca
authors.affiliation: ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Integrata di Trieste, Strada di Fiume 447, 34149 Trieste, Italy. Electronic address: francesca.boscolonata@gmail.com.
authors.forename: Francesca
authors.initials: F
authors.lastname: Boscolo Nata
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D003251:Constriction, Pathologic / Q000628:therapy; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D004106:Dilatation / Q000295:instrumentation* / Q000379:methods; D004940:Esophageal Stenosis / Q000150:complications / Q000628:therapy*; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D007013:Hypopharynx / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000628:therapy; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000628:therapy; D011183:Postoperative Complications / Q000628:therapy*; D011878:Radiotherapy; D000077195:Squamous Cell Carcinoma of Head and Neck; D014067:Tonsillar Neoplasms / Q000628:therapy
keywords: Dysphagia; Esophageal-stricture; Montgomery-salivary-bypass-tube; Oral-feeding; Quality-of-life