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).
[FIGURE OMITTED]
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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