Early oral hydration protects against pharyngocutaneous fistula after total laryngectomy or total pharyngolaryngectomy

Head & Neck ◽  
2020 ◽  
Vol 42 (8) ◽  
pp. 1902-1906 ◽  
Author(s):  
Matthieu Le Flem ◽  
Laure Santini ◽  
Carole Boulze ◽  
Abdallah Alshukry ◽  
Antoine Giovanni ◽  
...  
Keyword(s):  
Total Laryngectomy ◽  
Pharyngocutaneous Fistula ◽  
Oral Hydration ◽  
Total Pharyngolaryngectomy

Postlaryngectomy Pharyngocutaneous Fistula: Incidence, Predisposing Factors, and Therapy

2005 ◽  
Vol 133 (5) ◽  
pp. 689-694 ◽  
Author(s):  
Jacopo Galli ◽  
Eugenio De Corso ◽  
Mariangela Volante ◽  
Giovanni Almadori ◽  
Gaetano Paludetti
Keyword(s):  
Risk Factor ◽  
Total Laryngectomy ◽  
Radical Neck Dissection ◽  
Predisposing Factors ◽  
Spontaneous Closure ◽  
Pharyngocutaneous Fistula ◽  
Systemic Diseases ◽  
Surgical Closure ◽  
Number Of Factors ◽  
Wait And See

OBJECTIVE: The pharyngocutaneous fistula (PCF) is a serious complication after total laryngectomy, and its etiology is not well understood yet. The aim of our study was to evaluate predisposing factors, incidence, and management of this complication. STUDY DESIGN AND SETTING: This was a retrospective study of 268 patients who underwent total laryngectomy in our clinic (January 1990-December 2001). A number of factors potentially predisposing to PCF formation were evaluated. RESULTS: A PCF was observed in 16% of patients. Systemic diseases, previous radiotherapy, supraglottic origin of tumor, and concurrent radical neck dissection were significantly associated with PCF. Spontaneous closure was noted in 28 patients, whereas a surgical closure was necessary in 15 patients. CONCLUSIONS: In presence of a specific risk factor, PCF can be expected; nevertheless, its prevention remains very difficult. Moreover, given the high percentage of spontaneous closure, we suggest the “wait and see” approach for 28 days before proceeding with a surgical approach.

Pharyngocutaneous Fistula after Total Laryngectomy: Incidence, Cause, and Treatment

1994 ◽  
Vol 103 (10) ◽  
pp. 801-805 ◽  
Author(s):  
George Papazoglou ◽  
George Terzakis ◽  
George Doundoulakis ◽  
George Dokianakis
Keyword(s):  
Total Laryngectomy ◽  
Major Complication ◽  
Predisposing Factors ◽  
Morbidity And Mortality ◽  
Red Cross ◽  
Pharyngocutaneous Fistula ◽  
Common Complication ◽  
Methods Of Treatment

Postoperative pharyngocutaneous fistula is a major complication of total laryngectomy that prolongs the short hospitalization of 2 to 3 weeks to many weeks or even months. It is a common complication that increases the morbidity and mortality of the procedure. In the Department of Otolaryngology of the Red Cross Hospital of Athens, 310 patients underwent total laryngectomy from January 1980 through December 1989. Twenty-eight patients developed a fistula (incidence 9%). The incidence, predisposing factors, and methods of treatment of this complication are analyzed and discussed.

Utility of the Montgomery salivary tubes for preventing pharyngocutaneous fistula in total laryngectomy

2020 ◽  
Vol 41 (4) ◽  
pp. 102557
Author(s):  
Pablo Torrico Román ◽  
Agustín García Nogales ◽  
Gabriel Trinidad Ruíz
Keyword(s):  
Total Laryngectomy ◽  
Pharyngocutaneous Fistula

Effect of primary, cross-over, zigzag neopharyngoplasty on acoustic characteristics of alaryngeal, tracheoesophageal voice

2011 ◽  
Vol 125 (8) ◽  
pp. 841-848 ◽  
Author(s):  
O A Albirmawy
Keyword(s):  
Total Laryngectomy ◽  
Dynamic Range ◽  
Speaking Rate ◽  
University Hospital ◽  
Pharyngocutaneous Fistula ◽  
Acoustic Parameters ◽  
Tertiary Referral Centre ◽  
Voice Restoration ◽  
Fundamental Frequencies ◽  
Temporal Measures

AbstractObjective:To evaluate the effect of primary, cross-over, zigzag neopharyngeal construction on tracheoesophageal voice, compared with pharyngoesophageal myotomy, following total laryngectomy with partial pharyngectomy.Study design:Prospective clinical trial.Setting:Otolaryngology department, Tanta University Hospital (tertiary referral centre), Egypt.Patients and methods:Over five years, 30 patients underwent total laryngectomy with partial pharyngectomy to manage stage III or IV laryngeal cancer, followed by primary tracheoesophageal puncture for voice restoration. For neopharyngeal construction, 15 patients underwent pharyngoesophageal myotomy (group one) and 15 cross-over, zigzag neopharyngoplasty (group two). Acoustic parameters of tracheoesophageal voice were compared.Results:Most acoustic parameters were almost equivalent for the two groups, although significant differences were seen for loud intensity, dynamic range, shimmer, loud fundamental frequency, loud jitter, fluency and speaking rate. One post-operative pharyngocutaneous fistula (6.6 per cent) occurred in each group, and resolved with conservative measures.Conclusion:The cross-over neopharyngoplasty modification of hypopharyngeal closure may help avoid pharyngoesophageal spasm and assist maintenance of effective voice amplitude, fundamental frequencies, temporal measures and perceptual values.

Pharyngocutaneous fistula following total laryngectomy: a single institution’s 10-year experience

2006 ◽  
Vol 263 (12) ◽  
pp. 1127-1130 ◽  
Author(s):  
Antti A. Mäkitie ◽  
Riina Niemensivu ◽  
Mari Hero ◽  
Harri Keski-Säntti ◽  
Leif Bäck ◽  
...  
Keyword(s):  
Total Laryngectomy ◽  
Pharyngocutaneous Fistula

The techniques of nonmuscular closure of hypopharyngeal defect following total laryngectomy: the assessment of complication and pharyngoesophageal segment

1997 ◽  
Vol 111 (11) ◽  
pp. 1060-1063 ◽  
Author(s):  
Ching-Ping Wang ◽  
Tzu-Chan Tseng ◽  
Rheun-Chuan Lee ◽  
Shyue-Yih Chang
Keyword(s):  
Total Laryngectomy ◽  
Fistula Formation ◽  
Voice Rehabilitation ◽  
Pharyngocutaneous Fistula ◽  
Swallowing Function ◽  
Pharyngeal Muscle ◽  
Constrictor Muscle ◽  
Pharyngoesophageal Segment ◽  
Pharyngeal Muscles ◽  
Closure Group

AbstractThe usual method of reconstructing a hypopharyngeal defect during total laryngectomy includes pharyngeal muscle layer closure, which may result in high pharyngoesophageal pressure. We hypothesize that nonclosure of the pharyngeal muscle can reduce the pressure of the pharyngoesophageal segment which can reduce the chances of the formation of pharyngocutaneous fistulae. A technique of nonmuscular closure of a hypopharyngeal defect is presented. The differences in the rate of fistula formation and swallowing function between patients with usual and nonmuscular closure were also studied. Sixty consecutive laryngectomees were enrolled in this study. Thirty patients received usual closure after total laryngectomy, whereas the other 30 patients underwent non closure of their pharyngeal muscles. One patient (3.3 per cent) in the nonmuscular closure group and three patients (10 per cent) in the usual closure group developed a pharyngocutaneous fistula. The pharyngoesophageal pressures of the nonmuscular closure group were significantly lower than those of the usual closure group. We conclude that the technique of nonclosure of the pharyngeal constrictor muscle after total laryngectomy is relatively more simple and is not associated with a higher rate of fistula formation. Furthermore, nonclosure of the pharyngeal constrictor muscle is preferable to muscular closure because it reduces the spasm of the pharyngoesophageal segment which limits voice rehabilitation.

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