Postlaryngectomy Pharyngocutaneous Fistula: Incidence, Predisposing Factors, and Therapy

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  • Jacopo Galli
    Institute of Otolaryngology Università Cattolica del Sacro Cuore Rome Italy
  • Eugenio De Corso
    Institute of Otolaryngology Università Cattolica del Sacro Cuore Rome Italy
  • Mariangela Volante
    Institute of Otolaryngology Università Cattolica del Sacro Cuore Rome Italy
  • Giovanni Almadori
    Institute of Otolaryngology Università Cattolica del Sacro Cuore Rome Italy
  • Gaetano Paludetti
    Institute of Otolaryngology Università Cattolica del Sacro Cuore Rome Italy

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<jats:sec><jats:title>OBJECTIVE</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>STUDY DESIGN AND SETTING</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>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.</jats:p></jats:sec>

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