Percutaneous needle pharyngostomy

Pharyngostomy is a technique of proven usefulness in patients requiring extra oral enteric access. Techniques to perform this have required an operating room, general anesthesia, and the associated risks. We have developed a technique for needle pharyngostomy that can be performed at the bedside of an awake patient. We utilize a central venous catheter tray and a small bore feeding tube to do this procedure. We have performed this on 17 patients without a procedural complication. This form of enteric access has allowed total nutritional support for up to 2 yr. Two late infections at the pharyngostomy site have occurred; both were easily controlled with oral antibiotics. This technique is recommended for patients who repeatedly pull out feeding tubes or are planning home enteral nutrition.