A white, 63-year-old man came to our clinic 3 days after undergoing an endoscopic C[O.sub.2] laser radial incision and dilation of a 90% subglottic stenosis. The patient complained of aerophagia and excessive eructation. The patient was febrile (101.7[degrees]F) and had physical and radiologic evidence of pneumonia. The results of a barium swallow examination were normal. Because of the high index of suspicion for tracheoesophageal fistula (TEF), transnasal esophagoscopy was performed in the clinic.
Esophagoscopy revealed the presence of a 4 x 6-mm fistula on the anterolateral wall of the esophagus (figure, A). The TEF was also visible on tracheoscopy (figure, B).
From the Center for Voice Disorders, Department of Otolaryngology, Wake Forest University Medical Center, Winston-Salem, N.C.; www.thevoicecenter.org.
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