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. 2012 Dec;78(6):94-8.
doi: 10.5935/1808-8694.20120040.

[Pharyngocutaneous fistula following total laryngectomy]

[Article in Portuguese]
Felipe Toyama Aires  1 , Rogério Aparecido Dedivitis, Mario Augusto Ferrari de Castro, Daniel Araki Ribeiro, Claudio Roberto Cernea, Lenine Garcia Brandão
Affiliations

[Pharyngocutaneous fistula following total laryngectomy]

[Article in Portuguese]
Felipe Toyama Aires et al. Braz J Otorhinolaryngol. 2012 Dec.

Abstract

Pharyngocutaneous fistula (PCF) is the most common complication after total laryngectomy.

Objectives: To establish the incidence of this complication and to analyze the predisposing factors.

Method: This is a cross-sectional study of a historical cohort including 94 patients who underwent total laryngectomy. The following aspects were correlated to the occurrence of PCF: gender, age, tumor site, TNM staging, type of neck dissection, previous radiation therapy, previous tracheotomy, and use of stapler for pharyngeal closure. The following were considered in PCF cases: the day into postoperative care when the fistula was diagnosed, duration of occurrence, and proposed treatment.

Results: Twenty (21.3%) patients had PCF. The incidence of PCF was statistically higher in T4 tumors when compared to T2 and T3 neoplasms (p = 0.03). The other analyzed correlations were not statistically significant. However, 40.9% of the patients submitted to tracheostomy previously had fistulae, against 21.1% of the patients not submitted to this procedure.

Conclusion: Advanced primary tumor staging is correlated with higher incidences of PCF.

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