Clinical Analysis of Pharyngocutaneous Fistula after Total Laryngectomy

Rho, Young Soo; Kim, Chang Hoon; Jin, Jae Won; Kim, Jin Hwan; Ahn, Hwoe Young; Chung, Chul Hoon

Abstract

BACKGROUND AND OBJECTIVES: Pharyngocutaneous fistula after total laryngectomy is one of the most common complication in the immediate postoperative period. The objective of this study is to evaluate the variable predisposing factors after total laryngectomy and to investigate the management of pharyngocutaneous fistula.
SUBJECTS AND METHOD
One hundred fifty cases who had been performed total laryngectomy were investigated retrospectively. Fifteen of 150 cases (10.0%) developed pharyngocutaneous fistula after total laryngectomy. We analyzed clinical parameters such as age, sex, smoking, alcohol intake, DM (diabetes mellitus), hypertension, liver disease, postoperative hemoglobin, albumin etc.
RESULTS
Smoking, DM, hypertension, postoperative hemoglobin, postoperative albumin were significant factors associated with pharyngocutaneous fistula. Nine patients were managed with conservative treatment and six patients underwent surgical reconstruction by using pectoralis major myocutaneous flap. The average duration of oral feeding was 30 postoperative days in conservative treatment group and 83 postoperative days in surgical intervention group.
CONCLUSION
Pharyngocutaneous fistula may be preventable by correcting the predisposing factors. We must consider the initial size of fistula and the response of conservative treatment to determine methodology and timing of surgical management.