Comparative Study Between Double Layered Repair of Pharyngeal Mucosa Against Routine Single Layered Repair in Cases of "Total Laryngectomy with Partial Pharyngectomy" in Respect To Formation of Pharyngo-cutaneous Fistula

Abstract

Advanced glottic cancer (T3,N+ & T4) is usually treated in the majority of centres by total laryngectomy. Carcinoma of the larynx is one of the very few subsets of all cancers which have shown a decrease in the 5 year survival rate and this phenomenon has been attributed to a Pharyngo-cutaneous fistula is the most common complication after total laryngectomy. Comparative study between double layered repair of pharyngeal mucosa against routine single layered repair in cases of "total laryngectomy with partial pharyngectomy". All patients with the principal procedure of "total laryngectomy with partial pharyngectomy" in department of otorhinolaryngology and head-neck surgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India were included in this study. Out of the 20 patients who had undergone total laryngectomy irrespective of the type of mucosal repair, 5 (25 %) patients developed pharyngocutaneous fistula. Out of the 8 patients, with double layered mucosa repair, 1 (12.5 %) patient developed pharyngocutaneous fistula. Out of the 12 patients, with single layered mucosa repair, 4 (33 %) patients developed pharyngocutaneous fistula. Double layered repair of pharyngeal mucosa is associated with a lower incidence of pharyngocutaneous fistula formation and no increased incidence of dysphagia after complete radiotherapy as compared to single layered repair.

Keywords: Laryngeal neoplasms; Pharyngo-cutaneous fistula; Postoperative complications; Total laryngectomy.

Fig. 1

Diagrammatic representation of mucosal repair