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March 1985

Tube Esophagostomy: A New Technique in the Management of Long-term Swallowing Disorders

Author Affiliations

From the Cleveland Clinic Foundation.

Arch Otolaryngol. 1985;111(3):187-189. doi:10.1001/archotol.1985.00800050081012

• Surgeons whose patients require long-term management of nutritional intake must usually choose from among nasogastric tube feedings, hyperalimentation by intravenous route, and/or gastrostomy. Cervical esophagostomy has been a useful but not widely employed alternative. The advantages of cervical esophagostomy over other modalities include the avoidance of laparotomy, absence of a nasogastric tube, and lack of the complications of a long-term indwelling intravenous catheter. The disadvantages of standard esophagostomy include the need to wear a tube to keep the fistula open, leakage, and skin irritation. Dobie et al presented a skin flap esophagostomy technique in 1978. We report a variation of this concept that has resulted in no salivary leakage and that allows the patient to dispense a tube between feedings. It provides a directional stoma in which the internal orifice is considerably inferior to the external one, resulting in continence and thus preventing substantial leakage.

(Arch Otolaryngol 1985;111:187-189)