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Chronic sinusitis and bilateral deafness as a presentation of oesophageal stent failure: case report

Published online by Cambridge University Press:  01 May 2008

S Al-Zahid*
Affiliation:
Ear, Nose, and Throat Dept., Princess of Wales Hospital, Bridgend, Wales, UK
J Clarke
Affiliation:
Ear, Nose, and Throat Dept., Princess of Wales Hospital, Bridgend, Wales, UK
C Roberts
Affiliation:
Ear, Nose, and Throat Dept., Princess of Wales Hospital, Bridgend, Wales, UK
*
Address for correspondence: Dr Saif Al-Zahid, 13 Grafton Close, Penylan, Cardiff CF23 9JA, Wales, UK. E-mail: [email protected]

Abstract

Objective:

We report an extremely rare upper airway complication of oesophageal stent failure.

Case report:

A 58-year-old woman presented four months after having a covered (anti-reflux valve type) oesophageal stent placed for a benign oesophageal stricture. Abdominal radiography showed a broken fragment at the gastroesophageal junction and another fragment in the rectum. On presentation, the patient had pneumonia with sepsis which required intensive care management. After recovery, she developed sinus symptoms of facial pain, green nasal discharge and bilateral hearing loss. ENT review revealed bilateral otitis media with effusion. Flexible naso-endoscopy found a stent fragment lodged in the nasopharynx. The wire mesh fragment was removed under general anaesthetic and bilateral grommets inserted. The patient's symptoms resolved.

Conclusions:

To our knowledge, this is the first report in the world literature of a broken and migrated oesophageal stent presenting with chronic sinusitis and bilateral hearing loss. This case highlights the importance of examining the upper airways in such cases, and the need for further, long term studies of the complications of metallic, expandable stents.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Holtmann, G. Reflux disease: the disorder of the third millennium. Eur J Gastroenterol Hepatol 2001;13(suppl 1):S511Google ScholarPubMed
2 Tan, DS, Mason, RC, Adam, A. Minimally invasive therapy for advanced oesophageal malignancy. Clin Radiol 1996;51:828–36CrossRefGoogle ScholarPubMed
3 Siersema, PD, Hop, WC, Dees, J, Tilanus, HW, van Blankenstein, M. Coated self-expanding metal stent versus latex prostheses for esophagogastric cancer with special reference to prior radiation and chemotherapy: a controlled, prospective study. Gastrointest Endosc 1998;47:113–20Google Scholar
4 Shim, CS, Jung, IS, Cheon, YK. Management of malignant stricture of the esophagogastric junction with a newly designed self-expanding metal stent with an antireflux mechanism. Endoscopy 2005;37:335–9Google Scholar
5 Lee, SH. The role of oesophageal stenting in the non-surgical management of oesophageal strictures. Br J Radiol 2001;74:891900CrossRefGoogle ScholarPubMed
6 Cwikeil, W, Tanberg, K-G, Cwikeil, M, Lillo-Gil, R. Malignant dysphagia: palliation with esophageal stents – long-term results in 100 patients. Radiology 1998;207:513–18Google Scholar
7 Song, HY, Do, YS, Han, YM, Sung, KB, Choi, EK, Sohn, KH et al. Covered expandable oesophageal metallic stent tubes: experiences in 119 patients. Radiology 1994;193:689–95CrossRefGoogle ScholarPubMed
8 Acunas, B, Rozanes, I, Akpinar, S, Tunaci, A, Tunaci, M, Acunas, G. Palliation of malignant esophageal strictures with self-expanding Nitinol stents: drawbacks and complications. Radiology 1996;199:648–52Google Scholar
9 Wang, MQ, Sze, DY, Wang, ZP, Wang, ZQ, Gao, YA, Dake, MD. Delayed complications after esophageal stent placement for treatment of malignant esophageal obstructions and esophagorespiratory fistulas. J Vasc Interv Radiol 2001;12:465–74Google Scholar
10 Kawasaki, R, Sano, A, Matsumoto, S. Long-term outcomes and complications of metallic stents for malignant esophageal stenoses. Kobe J Med Sci 2003;49:133–42Google Scholar
11 Schoppmeyer, K, Golsong, J, Schiefke, I, Mössner, J, Caca, K. Antireflux stents for palliation of malignant esophagocardial stenosis. Diseases of the Esophagus 2007;20:8993Google Scholar