Patients with hypopharyngeal and cervical esophageal
strictures and
fistulas caused by advanced
malignancy, ingestion of
caustic material, or following surgery or
radiation therapy often suffer from marked
dysphagia. In such cases the implantation of a Montgomery Salivary Bypass Tube (
MSBT) can be an effective therapeutic option to bridge the fistulous tract or bypass a
stenosis. Being able to eat and drink without the need for intravenous supplementation or nasogastric or
gastrostomy tube feeding in general greatly improves the patient's quality of life. Since 1981 we have successfully inserted the
MSBT in 44 cases suffering from
dysphagia of different etiology. Our experiences with the indications for implantation, insertion techniques, and postoperative results are presented. Three selected cases of progressive
dysphagia in which the
MSBT is demonstrated to be the treatment of choice are described in more detail. In one case, a
tracheoesophageal fistula and in another a
stricture of the upper esophageal sphincter (UES) were bypassed so that oral intake of soft food became possible again. The third patient suffered from a disturbance of the esophageal motility after resection of a Hippel-Lindau
tumor in the spinal cord and syringe drainage; even swallowing saliva was impeded. After insertion of a
MSBT, uncomplicated soft food intake became possible again.