What Are Your Surgical Options for Dysphagia?

In some cases, surgery is a must in addressing dysphagia, a condition characterized by persistent difficulty in swallowing. Surgery is usually recommended when the underlying cause is GERD, pharyngoesophageal diverticulum, throat blockages, achalasia, or esophageal cancer.

The type of surgery will depend on the underlying cause. Furthermore, speech and swallowing therapy will likely be recommended after recovery from surgery. Here are three options that you may want to discuss with your ENT doctor.

Heller Myotomy

The Heller myotomy procedure is typically used in the treatment of achalasia, a disorder of the esophagus that makes swallowing abnormally difficult. This is a minimally invasive procedure wherein several tiny incisions are made in the esophagus, followed by the insertion of small scope into these tiny incisions.

The small scope has miniature surgical instruments passing through it while a video camera connected to it sends enlarged images of the esophagus to a monitor. The surgeon can then perform the operation by manipulating the miniature instruments in the scope.

The Heller myotomy procedure has several advantages that make it popular among surgeons and patients with dysphagia caused by achalasia. These include:

• Less pain after the operation since only minimal manipulation has been done
• Faster recovery
• Shorter stay in the hospital, usually 1-2 days, as compared with the possible 7-day stay for a conventional open procedure

In short, you can more quickly return to your normal activities and work.

Peroral Endoscopic Myotomy (POEM)

Yet another possible surgical option for the treatment of swallowing disorders like achalasia is peroral endoscopic myotomy (POEM). This is an endoscopic procedure wherein your surgeon inserts an endoscope through your mouth and down your throat. Your surgeon then makes an incision in your esophagus’ inner lining and cuts the muscle responsible for dysphagia.

POEM is an in-patient procedure requiring between two and three hours for completion. Like the Heller myotomy procedure, it’s popular because it doesn’t require incisions in the abdomen or chest. It also doesn’t require long hospital stays.

Esophageal Dilation

The medical professionals qualified to perform an esophageal dilation are otolaryngologists, or ear, nose and throat specialists, and gastroenterologists. Esophageal dilation stretches the abnormally narrow passages of the esophagus, known as strictures, which can be caused by underlying medical conditions.

In it, your ENT doctor inserts an endoscope into your esophagus, just as with the POEM procedure. He then inflates the balloon attached to the endoscope, which results in the gentle expansion of the strictures.

Esophageal dilation is performed as a treatment for certain swallowing disorders like:

• Achalasia, wherein the sphincter muscle in the esophagus becomes abnormally tight
• Esophageal stricture, or the narrowing of the esophagus
• Schatzki’s ring, an abnormal ring of tissue at the point where the esophagus and stomach meet

These three surgical options have their pros and cons in terms of the success rate, total cost and risks for side effects and complications. You should be well aware of these things before going under the knife, so to speak.

For details of our ENT services, diagnosis, and treatment, please consult our ENT specialist.

Source:

HK ENT Specialist Ltd.

Hong Kong based ENT clinic centre

For ENT Services, Audiology & Speech Therapy,

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