Prevalence of Esophageal Webs in Patients Undergoing Direct Laryngoscopy.

Abstract

The prevalence of esophageal webs in the pharyngoesophageal segment (PES) is unknown, in part because webs produce inconsistent symptomatology and can be difficult to diagnose. This study aims to determine the prevalence of PES webs in patients undergoing endoscopic laryngeal surgery. This retrospective cohort study included patients undergoing laryngoscopy for pathology unrelated to webs. Evaluation for the presence of a web was performed on standard/routine examination of the PES during direct laryngoscopy. Demographic and clinical factors were analyzed for associations with webs. Of 123 patients included in this study, 42 (34.1%) were found to have a PES web. A total of 22 webs (52.4%) were on the left, 16 (38.1%) were on the right, and 4 (9.5%) were bilateral. There was no difference in age (58.1 vs. 58.7, p = 0.864) or BMI (29.7 vs. 29.8, p = 0.900) between patients with and without PES webs. Webs were significantly more common in patients with a history of irradiation to the head and neck (70% vs. 31%, p = 0.031) with a RR of 2.26 (CI: 1.38-3.69). There was no association of webs with gender, race, history of gastroesophageal reflux disease, or other clinical factors. Only 33.3% of patients with a web had documented symptoms of dysphagia. PES webs may be more prevalent than what is historically cited in the literature, and webs may be more common in patients with a history of irradiation to the head and neck.