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- Publisher Website: 10.1055/s-0043-110670
- Scopus: eid_2-s2.0-85020213444
- PMID: 28564716
- WOS: WOS:000408567500015
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Article: Clinical utility of a functional lumen imaging probe in management of dysphagia following head and neck cancer therapies
Title | Clinical utility of a functional lumen imaging probe in management of dysphagia following head and neck cancer therapies |
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Authors | |
Issue Date | 2017 |
Citation | Endoscopy, 2017, v. 49, n. 9, p. 848-854 How to Cite? |
Abstract | Background and aims Chemoradiotherapy for head and neck cancer (HNC) with/without laryngectomy commonly causes dysphagia. Pharyngoesophageal junction (PEJ) stricturing is an important contributor. We aimed to validate a functional lumen imaging probe (the EndoFLIP system) as a tool for quantitating pretreatment PEJ distensibility and treatment-related changes in HNC survivors with dysphagia and to evaluate the diagnostic accuracy of EndoFLIP-derived distensibility in detecting PEJ strictures. Methods We studied 34 consecutive HNC survivors with long-term (>12 months) dysphagia who underwent endoscopic dilation for suspected strictures. Twenty non-dysphagic patients undergoing routine endoscopy served as controls. PEJ distensibility was measured at endoscopy with the EndoFLIP system pre- and post-dilation. PEJ stricture was defined as the presence of a mucosal tear post-dilation. Results PEJ stricture was confirmed in 22/34 HNC patients (65%). During distension up to 60mmHg, the mean EndoFLIP-derived narrowest cross-sectional area (nCSA) in HNC patients with strictures, without strictures, and in controls were 58mm 2 (95% confidence interval [CI] 22 to 118), 195mm 2 (95%CI 129 to 334), and 227mm 2 (95%CI 168 to 316), respectively. A cutoff of 114mm 2 for the nCSA at the PEJ had perfect diagnostic accuracy in detecting strictures (area under the receiver operating characteristic curve=1). In patients with strictures, a single session of dilation increased the nCSA by 29mm 2 (95%CI 20 to 37; P <0.001). In patients with no strictures, dilation caused no change in the nCSA (mean difference 13mm 2 [95%CI -4 to 30]; P =0.13). Conclusions EndoFLIP is a highly accurate technique for the detection of PEJ strictures. EndoFLIP may complement conventional diagnostic tools in the detection of pharyngeal outflow obstruction. |
Persistent Identifier | http://hdl.handle.net/10722/301815 |
ISSN | 2023 Impact Factor: 11.5 2023 SCImago Journal Rankings: 1.422 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Wu, Peter I. | - |
dc.contributor.author | Szczesniak, Michal M. | - |
dc.contributor.author | Maclean, Julia | - |
dc.contributor.author | Choo, Lennart | - |
dc.contributor.author | Quon, Harry | - |
dc.contributor.author | Graham, Peter H. | - |
dc.contributor.author | Zhang, Teng | - |
dc.contributor.author | Cook, Ian J. | - |
dc.date.accessioned | 2021-08-19T02:20:48Z | - |
dc.date.available | 2021-08-19T02:20:48Z | - |
dc.date.issued | 2017 | - |
dc.identifier.citation | Endoscopy, 2017, v. 49, n. 9, p. 848-854 | - |
dc.identifier.issn | 0013-726X | - |
dc.identifier.uri | http://hdl.handle.net/10722/301815 | - |
dc.description.abstract | Background and aims Chemoradiotherapy for head and neck cancer (HNC) with/without laryngectomy commonly causes dysphagia. Pharyngoesophageal junction (PEJ) stricturing is an important contributor. We aimed to validate a functional lumen imaging probe (the EndoFLIP system) as a tool for quantitating pretreatment PEJ distensibility and treatment-related changes in HNC survivors with dysphagia and to evaluate the diagnostic accuracy of EndoFLIP-derived distensibility in detecting PEJ strictures. Methods We studied 34 consecutive HNC survivors with long-term (>12 months) dysphagia who underwent endoscopic dilation for suspected strictures. Twenty non-dysphagic patients undergoing routine endoscopy served as controls. PEJ distensibility was measured at endoscopy with the EndoFLIP system pre- and post-dilation. PEJ stricture was defined as the presence of a mucosal tear post-dilation. Results PEJ stricture was confirmed in 22/34 HNC patients (65%). During distension up to 60mmHg, the mean EndoFLIP-derived narrowest cross-sectional area (nCSA) in HNC patients with strictures, without strictures, and in controls were 58mm 2 (95% confidence interval [CI] 22 to 118), 195mm 2 (95%CI 129 to 334), and 227mm 2 (95%CI 168 to 316), respectively. A cutoff of 114mm 2 for the nCSA at the PEJ had perfect diagnostic accuracy in detecting strictures (area under the receiver operating characteristic curve=1). In patients with strictures, a single session of dilation increased the nCSA by 29mm 2 (95%CI 20 to 37; P <0.001). In patients with no strictures, dilation caused no change in the nCSA (mean difference 13mm 2 [95%CI -4 to 30]; P =0.13). Conclusions EndoFLIP is a highly accurate technique for the detection of PEJ strictures. EndoFLIP may complement conventional diagnostic tools in the detection of pharyngeal outflow obstruction. | - |
dc.language | eng | - |
dc.relation.ispartof | Endoscopy | - |
dc.title | Clinical utility of a functional lumen imaging probe in management of dysphagia following head and neck cancer therapies | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1055/s-0043-110670 | - |
dc.identifier.pmid | 28564716 | - |
dc.identifier.scopus | eid_2-s2.0-85020213444 | - |
dc.identifier.volume | 49 | - |
dc.identifier.issue | 9 | - |
dc.identifier.spage | 848 | - |
dc.identifier.epage | 854 | - |
dc.identifier.eissn | 1438-8812 | - |
dc.identifier.isi | WOS:000408567500015 | - |