Transcutaneous cervical miniesophagostomy

Abstract

Nasogastric tubes have been shown to cause damage to the pharyngolaryngeal complex, producing laryngeal inflammation, granulation, muscle damage, and even vocal cord immobility. The coexistence of nasogastric and tracheotomy tubes after conservation laryngeal surgery is especially harmful. The friction between these two semirigid structures may result in damage to the remaining part of the larynx. This may result in a significant delay in healing, oral feeding, and decannulation. Percutaneous endoscopic gastrostomy is a possible solution. This procedure requires time, special expertise, and cooperation between services. We present our experience with 17 transcutaneous cervical miniesophagostomies using a small-caliber feeding tube, which were performed during conservation laryngeal and/or pharyngeal surgery. The rate of minor complications was 11.7%, or 0.40 complications per 100 tube days, and no major complications were related to the procedure. Transcutaneous cervical miniesophagostomy is a simple and quick procedure that may be performed during the primary cancer surgery. It is done by the head and neck surgeon and does not require special expertise. It takes about 5 minutes to perform and, if done correctly with tunneling under skin flaps, is associated with minimal or no postoperative morbidity. (OTOLARYNGOL HEAD NECK SURG 1995;113:387-92.)