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Post-laryngectomy pharyngocutaneous fistula – a still unresolved problem

Published online by Cambridge University Press:  29 June 2007

Milo Fradi ,
Ludwig Podoshin  and
Jaacov Ben David
Milo Fradi
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Bnai Zion Medical Centre, The Bruce Rappaport Faculty of Medicine, Technion-lsrael Institute of Technology, Haifa, Israel
Ludwig Podoshin*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Bnai Zion Medical Centre, The Bruce Rappaport Faculty of Medicine, Technion-lsrael Institute of Technology, Haifa, Israel
Jaacov Ben David
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Bnai Zion Medical Centre, The Bruce Rappaport Faculty of Medicine, Technion-lsrael Institute of Technology, Haifa, Israel
*
Address for correspondence: Professor L. Podoshin, Department of Otolaryngology, Bnai Zion Medical Centre, POB 4940, Haifa 31048, Israel
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Abstract

Fifty-six total laryngectomy cases are presented with special reference to post-operative fistula formation. All these patients were operated upon at the Department of Otorhinolaryngology at the Bnai Zion Medical Centre by one surgeon over a 16-year period, from 1976–1992. The incidence of fistula was 12.5 percent. This paper could not verify reports that any specific factors were significantly related to fistula formation, although there was a preponderance of fistulas in patients presenting with late stage tumours. No relationship was found with rate of infection, age, or between previous neck irradiation (ranging from 5500 to 7000 cGy) and fistula formation in the patient population.

If a fistula occurs, the administration of oral solid food keeping the nasogastric tube in place for administration of fluids may lead to spontaneous closure of the fistula, with no need for secondary surgical repair.

Keywords

Laryngectomy, complicationsFistula
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 3 , March 1995 , pp. 221 - 224
Copyright
Copyright © JLO (1984) Limited 1995

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