Kiminori Aoyama, Satoshi Yokoyama, Shion Wakamatsu, Ryohei Uozumi
We report a man in his late 50s who remained dependent on tube-feeding after circumferential tracheal resection with partial resection of the suprahyoid muscle and hyoid bone.
Severe dysphagia after tracheal resection may result from reduced hyolaryngeal traction and restricted upper oesophageal sphincter (UES) opening. We report a man in his late 50s who remained dependent on tube-feeding after circumferential tracheal resection with partial resection of the suprahyoid muscle and hyoid bone. Compensatory strategies provided limited benefit. UES-directed balloon dilation, guided and monitored by serial video-fluoroscopic swallowing study and fibreoptic endoscopic evaluation of swallowing, was associated with an immediate increase in UES opening from approximately 3 mm to 10 mm after the first session, followed by gradual progression to full oral intake. The Hyodo score improved from 6 to 3, the Dysphagia Severity Scale from 2 to 6 and the Functional Oral Intake Scale from 3 to 6. This case report may help clinicians consider treatment options in similarly complex cases for which evidence-based guidance may be limited by patient-specific features.