Incidence, Risk Factors and Management of Pharyngeal Fistulae Following Total Laryngectomy, NCI Case Series (original) (raw)

Pharyngocutaneous fistula is a common and troublesome postoperative complication after total laryngectomy. The objective of this study was to determine the incidence, predisposing factors, and outcome of post laryngectomy pharyngo-cutaneous fistula in patients operated on in our department and to describe the management of such complication. The medical records of 100 consecutive patients who underwent laryngeal surgery for squamous cell carcinoma of the larynx between 2000 and 2008 were studied. All patients had similar preoperative and postoperative care. We studied a number of factors that could influence fistula formation such as age, gender, smoking, systemic disease, preoperative radiotherapy, site of tumor, surgical procedure, positive surgical margins, type of closure (T vs. vertical), concurrent neck dissection, clinical stage, and pathological grade. A pharyngocutaneous fistula was observed in 25% of the patients within a mean time of 9.6 days from surgery. Spontaneous clo...