Serious laryngeal edema during endoscopic resection for squamous cell carcinoma of the esophagus

The detection of early esophageal squamous cell carcinoma (ESCC) in patients following radiotherapy for squamous cell carcinoma of the head and neck (HNSCC) has increased with the development of endoscopic technologies. The aim of the current case – control study was to elucidate the risk factors of serious laryngeal edema, a lethal complication that occurs during endoscopic resection for ESCC. Among 184 consecutive patients who were treated by endoscopic resection for ESCC between January 2009 and May 2012, five of 22 patients with a history of radiotherapy for HNSCC suffered from serious laryngeal edema, which was not observed in patients who had not undergone radiotherapy. The susceptibility to serious laryngeal edema in patients with a history of radiotherapy followed by neck dissection for HNSCC was significantly greater than those without such histories. Despite the limited number of cases, we suggest that previous radiotherapy followed by neck dissection for HNSCC might be a predictive factor for serious laryngeal edema during endoscopic resection.

• References

• 1 Muto M, Hironaka S, Nakane M et al. Association of multiple lugol-voiding lesions with synchronous and metachronous esophageal squamous cell carcinoma in patients with head and neck cancer. Gastrointest Endosc 2002; 56: 517-521
• 2 Bhide SA, Nutting CM. Advances in radiotherapy for head and neck cancer. Oral Oncol 2010; 46: 439-441
• 3 Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 1995; 31: 1341-1346
• 4 Ichimura K, Sugasawa M, Nibu K et al. The significance of arytenoid edema following radiotherapy of laryngeal carcinoma with respect to residual and recurrent tumour. Auris Nasus Larynx 1997; 24: 391-397
• 5 The Japanese Society for Esophageal Diseases. Esophageal cancer treatment guidelines. Tokyo: Kanehara; 2007
• 6 Sofferman RA, Hubbell RN. Laryngeal complications of nasogastric tubes. Ann Otol Rhinol Laryngol 1981; 90: 465-468
• 7 Koga Y, Mishima Y, Saho M et al. A case of serious laryngeal edema unpredictably detected during laryngoscopy for orotracheal intubation following induction of anathesia. J Anesth 2011; 25: 589-591
• 8 The Japanese Society for Head and Neck Cancer. General rules for clinical and pathological studies on head and neck cancer. Tokyo: Kanehara; 2005
• 9 Sieg A, Hachmoeller-Eisenbach U, Eisenbach T. Prospective evaluation of complications in outpatient GI endoscopy: a survey among German gastroenterologists. Gastrointest Endosc 2001; 53: 620-627
• 10 Burkle CM, Walsh MT, Pryor SG et al. Severe postextubation laryngeal obstruction: The role of prior neck dissection and radiation. Anesth Analg 2006; 102: 322-325
• 11 Wittekamp B, van Mook WN, Tjan DH et al. Clinical review: post-extubation laryngeal edema and extubation failure in critically ill adult patients. Crit Care 2009; 13: 233