Balloon dilation therapy for severe postoperative dysphagia after tracheal resection

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.