Reply to the Letter to the Editor regarding “Early oral hydration protects against pharyngocutaneous fistula after total laryngectomy or total pharyngolaryngectomy”

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.

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

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949410301010 ◽

1994 ◽

Vol 103 (10) ◽

pp. 801-805 ◽

Cited By ~ 64

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.

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

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2020.102557 ◽

2020 ◽

Vol 41 (4) ◽

pp. 102557

Author(s):

Pablo Torrico Román ◽

Agustín García Nogales ◽

Gabriel Trinidad Ruíz

Keyword(s):

Total Laryngectomy ◽

Pharyngocutaneous Fistula

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215111000910 ◽

2011 ◽

Vol 125 (8) ◽

pp. 841-848 ◽

Cited By ~ 1

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.

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