Cervical oesophagostomy in patients with severe dysphagia following radiotherapy for nasopharyngeal carcinoma

J Laryngol Otol. 2014 Feb;128(2):142-6. doi: 10.1017/S0022215113003423. Epub 2014 Jan 28.

Abstract

Objective: This study aimed to investigate the validity and feasibility of cervical oesophagostomy as a treatment for patients with severe dysphagia after radiotherapy for nasopharyngeal carcinoma.

Methods: The study retrospectively analysed the clinical data, symptoms, physical signs, treatment and outcomes of 12 patients treated with cervical oesophagostomy for severe dysphagia after radiotherapy for nasopharyngeal carcinoma, from 2006 to 2010.

Results: In all 12 cases, the oesophageal stoma remained stable, without any complications such as pharyngeal fistula or inflammation. No oesophageal stricture or granuloma growth was observed. All patients reported significant improvement in their nutritional status and quality of life after the oesophagostomy surgery.

Conclusion: Cervical oesophagostomy is a valid and feasible method of treating severe dysphagia following radiotherapy for nasopharyngeal carcinoma. Oesophagostomy shows specific advantages over nasogastric tubing, gastrostomy and jejunostomy. Patients' nutrition and quality of life can be improved significantly if cervical oesophagostomy is executed in a timely fashion, especially in cases with severe trismus and multiple radiation-induced cranial nerve palsies unresponsive to rehabilitation.

MeSH terms

  • Adult
  • Aged
  • Carcinoma
  • Deglutition Disorders / etiology
  • Deglutition Disorders / surgery*
  • Esophagostomy* / adverse effects
  • Esophagostomy* / methods
  • Humans
  • Male
  • Middle Aged
  • Nasopharyngeal Carcinoma
  • Nasopharyngeal Neoplasms / radiotherapy*
  • Retrospective Studies
  • Treatment Outcome