[Dysphagia] Self-dilatation

[magjim2 at msn.com (magjim r)]

I have a 57 year old patient who is s/p tonsillar cancer, treated with 
surgical resection and radiation in 1997.  His history is very complicated, 
and I won't go into detail here, but he wants to keep eating orally as long 
as possible in spite of very difficult swallowing problems.  He has 
Barrett's esophagus and has biopsy done once a year and also has a 
dilatation about once a year.  The physician had difficulty passing the 
pediatric scope for a biopsy yesterday - the patient had to help the 
physician advance the scope during the procedure!  I was thinking about 
self-dilation as one possible route for this patient.

What are pro/con's to self dilation?  What type of dialator is used and how 
often?  Has anybody used this successfully (or not) with their patients? I'd 
just like to hear from some of you regarding your experiences with this.

Thank you!

Maggie Richardson, CCC-SLP
Farmington, NM