This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Endoscopy of Upper Aerodigestive Tract  • Surgery  • Alert me on articles by topic  Social Bookmarking   What's this?

Catherine J. Rees, MD; Taylor Fordham, MD; Peter C. Belafsky, MD, PhD

Arch Otolaryngol Head Neck Surg. 2009;135(8):781-783.

Objective  To describe the safety of transnasal balloon dilation of the esophagus.

Design  Retrospective case series.

Setting  Two tertiary care institutions.

Patients  All patients undergoing transnasal balloon dilation of the esophagus.

Main Outcome Measure  Complications.

Results  Fifty-four transnasal esophageal balloon dilations were performed in 38 patients. The mean age of the cohort was 65 years (range, 13-88 years). Twenty-nine patients were male (76%). Twenty procedures were performed using only topical anesthesia in the office setting. Seven patients (18%) were postlaryngectomy, and 15 patients (39%) had a history of head and neck radiation therapy. The upper esophageal sphincter (UES) was the most frequent dilation site (63%), followed by proximal/mid esophagus (26%), lower esophageal sphincter (LES) (7.4%), and both the UES and LES (3.7%). Indications included cricopharyngeal dysfunction, benign stricture, web, and Schatzki ring. Two procedures (3.7%) were aborted secondary to self-limited laryngospasm or gagging. There were no clinically significant complications.

Conclusions  Transnasal esophageal balloon dilation can be performed in unsedated or sedated patients with a very low complication rate. The procedure is well tolerated in 96% of patients. This technique, formerly available only through larger caliber oral gastroscopes and under sedation, allows for office-based esophageal balloon dilation in an otolaryngology practice.

Author Affiliations: Center for Voice and Swallowing Disorders, Wake Forest University School of Medicine, Winston Salem, North Carolina (Drs Rees and Fordham); Center for Voice and Swallowing, University of California–Davis School of Medicine, Sacramento (Dr Belafsky).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?