Dilation of proximal esophageal strictures following therapy for head and neck cancer: Experience with savary gilliard dilators

Background: There is little information on dilation of proximal strictures following surgical and/or radiation therapy for head and neck cancer. We studied the feasibility and efficacy of dilating proximal strictures following therapy for head and neck cancer using Savary Gilliard dilators. Methods: Twenty-one consecutive patients with proximal strictures resulting from surgery and/or radiation therapy of head and neck cancer were studied. Savary Gilliard dilation was performed using the standard and a modified method. Dysphagia was graded before and after dilation using a 5- point scale. Results: Technical success, dysphagia relief, complications, and duration of relief were noted. Technical success was achieved in 20 (95%) patients. Adequate dysphagia relief was obtained in 15/20 (75%) patients, which lasted for 4-36 weeks (median 14 weeks). There were no perforations, bleeding, or deaths. Four patients required repeat dilation after a median interval of 12 weeks. Conclusions: Savary Gilliard dilation is a safe and effective method for dilating strictures caused by therapy for head and neck cancer.