Dilation of an esophageal stricture caused by epidermolysis bullosa. (Esophagoscopy Clinic).
In light of the significant risk that intubation poses in a patient with active epidermolysis bullosa, we elected to perform esophageal dilation in the clinic with Savary dilators (figure, D). Our technique for in-office dilation involves the direct visualization of the area of stricture with a transnasal esophagoscope. A Savary dilator guidewire is inserted through the instrument's biopsy port. Then the esophagoscope is removed, leaving the wire in place as it passes through the stricture and out the patient's nose. A Kelly clamp is used to reach into the patient's mouth and withdraw the wire transorally. Progressively larger Savary dilators are then advanced over the wire to dilate the stricture. Our patient tolerated the procedure easily and did not require sedation. At the 4-month follow-up, he was still eating without difficulty.
From the Center for Voice Disorders, Department of Otolaryngology, Wake Forest University Medical Center, Winston-Salem, N.C.; www.thevoicecenter.org
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|Comment:||Dilation of an esophageal stricture caused by epidermolysis bullosa. (Esophagoscopy Clinic).|
|Author:||Koufman, James A.|
|Publication:||Ear, Nose and Throat Journal|
|Article Type:||Brief Article|
|Date:||Feb 1, 2002|
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