Local triamcinolone acetonide injection for the prevention of pharyngeal deformity following endoscopic submucosal dissection of superficial pharyngeal neoplasms.

backgroundExtensive mucosal resection following endoscopic submucosal dissection (ESD) for hypopharyngeal neoplasms can result in scar contracture and pharyngeal deformity, potentially increasing the risk of aspiration pneumonia. This study aimed to evaluate the efficacy and safety of local triamcinolone acetonide (TA) injection for preventing post-ESD pharyngeal deformity.

methodsThis retrospective cohort study included 388 patients who underwent ESD for hypopharyngeal neoplasms between 2011 and 2026. Patients were divided into those who received local TA injection after ESD (TA group, n = 65) and those who did not (control group, n = 323). Post-ESD pharyngeal deformity was classified into four grades based on endoscopic findings. The piriform sinus was subdivided into three subfields according to the extent of the mucosal defect.

resultsThe TA group had a significantly lower deformity severity and fewer grade ≥ 2 deformities than the control group (both p < .001). Significant preventive effects were observed only in the piriform sinus (both p < .001). Among mucosal defects involving multiple piriform sinus subfields, both outcomes were significantly lower in the TA group for mucosal defects involving two (p < .001 and p = .046, respectively) and three (both p < .001) subfields. Similar findings were observed after propensity score matching. No adverse events related to TA injection were observed.

conclusionsLocal TA injection may be an effective and safe strategy for preventing post-ESD pharyngeal deformity, particularly in mucosal defects involving multiple piriform sinus subfields.