SLPCase SeriesDysphagia2022

Feasibility and Safety of Office-Based Transnasal Balloon Dilation for Neopharyngeal and Proximal Esophageal Strictures in Patients with a History of Head and Neck Carcinoma.

Anouk S Schimberg, David J Wellenstein, Henrieke W Schutte and 4 others

PMID 33689024

WHAT IT FOUND

Office-based balloon dilation through the nose was feasible and well-tolerated in 12 patients with head and neck cancer strictures.

However, swallowing scores did not improve significantly one month later, and effects were transient in some patients.

Key findings

01The procedure was feasible and safe, with high completion rates and only one minor complication (infection) across 26 procedures.

02Patients tolerated the procedure well, with median pain and discomfort scores of 3 or below on a 10-point scale.

03Dysphagia scores did not improve significantly one month post-treatment (p = 0.096), although 67% of patients self-reported improvement.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study population was very small (12 patients), which limits the generalizability of the findings. The follow-up period was short (one month), so long-term effectiveness and recurrence rates are unknown. The study lacked a control group, making it impossible to attribute changes in dysphagia solely to the intervention versus natural history or other factors. The primary objective was feasibility and safety; effectiveness was a secondary exploratory outcome, and the results were not statistically significant.

Declared interests

The study was funded by Pentax Medical, the manufacturer of the endoscope used in the procedure.

The easy way to misread this

Do not interpret the 67% self-reported improvement as evidence that the procedure effectively treats dysphagia. The objective dysphagia scores did not improve significantly (p = 0.096), and the study was too small and short to prove efficacy.

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