Study of pharyngocutaneous fistula following total laryngectomy

The objective of this study was to investigate the incidence and risk factors of pharyngocutaneous fistula following total laryngectomy. Patients: The study subjects included 45 patients who had received total laryngectomy at Jichi Medical University Hospital, between July 1, 1998 and June 30, 2006. Results: Pharyngocutaneous fistulae developed in 8 patients (18%). Two patients bled from the common carotid artery. There was no significant association between the following items and the incidence of fistula: the surgeon performing the operation, age, laryngectomy etiology, history of smoking, presence of diabetes, preoperative tracheostomy, preoperative partial laryngectomy, combined neck dissection, combined thyroidectomy, low serum albumin level and anemia. The incidence of fistula was significantly higher in patients undergoing concomitant radio chemotherapy. Postoperative hospitalization was significantly longer in the patients who developed fistula. Conclusion: The development of a pharyngocutaneous fistula represents a troublesome complication that often results in increased morbidity and hospitalization time. Following laryngectomy, it is necessary to perform a detailed check of local and systemic conditions and to give postoperative care. When a fistula forms, early and appropriate care is necessary.