A Simple Combined Antegrade Radiological and Retrograde Endoscopic Procedure to Recanalise Fibrotic Hypopharyngo-Oesophageal Occlusions: Technical Description and Lessons from Clinical Outcome in Three Cases *

摘要: Background: Complete hypopharyngo-oesophageal occlusion is a rare complication of head and neck radiotherapy range other conditions. Absolute dysphagia accompanied by aspiration dependence on gastrostomy feeding. The condition presents substantial management challenge. Surgical approaches to re-establish pharyngo-oesophageal continuity are varied, highly invasive associated with unpredictable outcomes. Minimally techniques employing endoscopic radiological emerging. This report describes multidisciplinary approach which translates two interventional radiology used in the central venous occlusions biliary strictures three cases complete occlusion. Methods: Three different underlying aetiologies had treatment initiated between 2009 2011. Antegrade pharyngoscopic access was retrograde via small gastrostomy. Luminal re-established technique “sharp recanalisation” followed passage wide bore nasogastric tube maintained situ for 4-6 months, duration analogous that applied fibrotic strictures. After contrast swallows examination performed gauge calibre lumen, assess functionality rule out aspiration. Results: Pharyngo-oesophageal all first attempt. No complications occurred as result procedures. In cases, excellent swallowing function re-established, although one these required prolonged post-treatment adjuvant interventions. case no resulted, despite apparently successful re-establishment luminal continuity. Conclusions: lumen A minimally combining antegrade resulted lumen. However variable responses suggest both aetiology chronicity may influence likelihood functional outcome. Until definitive guidelines established, we such managed only motivated teams keen develop their expertise this area.