Radiation-Related Hypopharynx-Stenosis with Spared Larynx Treated by a Novel-Shaped Silicone Stent

Michael A. Herzog, A. Velten, Benjamin Velten, V. Bogdanov, D. Grafmans
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Abstract

Background: Radiation-related hypopharyngeal stenoses are considered as complications after larynx sparing therapy of hypopharyngeal or laryngeal tumors. Methods: The reported patient suffered from chondronecrosis of the cricoid after radiation of a larynx carcinoma and was treated by removing the necrotic cartilage. To prevent emerging stenosis of the hypopharynx, a customized hypopharyngeal stent was constructed on the basis of CT scan data. The Y-shaped stent was placed dorsal to the larynx, caudal to the arytenoid cartilages and remained in place without dislocation or irritation of the larynx for 8 weeks. During that time, the hypopharynx was stented, and the mucosa grew around the stent covering the complete circumference of the hypopharynx again. 18 weeks after removal of the stent, the hypopharynx did not reveal any re-stenosis. Conclusion: This customized hypopharyngeal stent is the first reported approach applied with spared larynx, which has been tolerated for a long period of time.
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新型硅胶支架治疗放射相关性下咽狭窄伴保留喉
背景:放射相关的下咽狭窄被认为是下咽或喉部肿瘤保喉治疗后的并发症。方法:本病例为喉癌放射治疗后环状软骨坏死患者,采用切除坏死软骨的方法治疗。为防止下咽出现狭窄,根据CT扫描数据定制下咽支架。y形支架放置于喉背侧、杓状软骨尾侧,8周内未发生脱位或刺激喉。在此期间,下咽植入支架,粘膜在支架周围生长,再次覆盖下咽的完整周长。移除支架18周后,下咽未发现再狭窄。结论:这种定制的下咽支架是首次报道的适用于保留喉的入路,并且长期耐受。
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