Hydrostatic balloon dilatation of pharyngeal stricture under local anaesthetic

Abstract

Balloon dilatation is well established in the management of enteric strictures. The use of this technique in the pharynx has been reported under radiological and endoscopic guidance. We describe the hydrostatic dilatation of a benign pharyngeal stricture in a laryngectomy patient under local anaesthetic, without radiological guidance, in the ENT out-patient department. This procedure was effective and well tolerated in a patient who required regular dilatations.

Office-based procedures for diagnosis and treatment of esophageal pathology

“…Indications and interventions for which transnasal esophagoscopy are used are displayed in Table . Overall, patients reported good tolerability of transnasal esophagoscopy while under topical anesthesia, and some studies even found better tolerability compared to transoral esophagoscopy under topical anesthesia or sedation .…”

“…Another method is dilating over a guidewire or with mercury‐weighted dilators, which do not need a wire . Since the introduction of balloon dilatation in 1981, this procedure has become an alternative method of esophageal dilatation . Rees described her technique for balloon dilatation, with the patient under topical anesthesia, by inserting the endoscope and guidewire transnasally and positioning them so the transparent dilating balloon could be visualized.…”

“…With the emergence of transnasal esophagoscopy, esophageal dilatation in outpatient clinics with the patients under topical anesthesia is another possible office‐based procedure. Several authors concluded that balloon dilatation is more effective and feasible compared to the use of bougies in the office‐based setting, with better visualization of the esophageal stricture and causing less trauma …”

“…Several authors concluded that balloon dilatation is more effective and feasible compared to the use of bougies in the office-based setting, with better visualization of the esophageal stricture and causing less trauma. [79][80][81] In the current literature search, we only found 1 study in which 20 unsedated balloon dilatations were performed in an office-based setting. 80 Although it is possible that studies were missed in the search, based on the current information, balloon dilatation under topical anesthesia has not been adequately investigated.…”

Advances in office‐based diagnosis and treatment in laryngology

“…Procedural indications include biopsies of the laryngopharynx and esophagus, esophageal, neopharyngeal, and nasopharyngeal stricture balloon dilation,83–85 secondary tracheoesophageal puncture,86, 87 the delivery of flexible lasers, delivery of feeding tubes, injection of Botox into the esophagus,88 and the insertion of wireless pH monitoring devices 89…”