Pharyngocutaneous fistula repair: case report and review of management strategies

Authors

  • Raj Nagarkar HCG Manavata cancer centre, Nashik, Maharashtra, India
  • Gauri Sayaji Kokane Department of Head and neck surgical oncology, HCG Manavata cancer centre, Nashik, Maharashtra, India
  • Ashvin Wagh Department of Head and neck surgical oncology, HCG Manavata cancer centre, Nashik, Maharashtra, India
  • Shrikant Vanjari Department of Head and neck surgical oncology, HCG Manavata cancer centre, Nashik, Maharashtra, India
  • Sachin Bansod Department of Head and neck surgical oncology, HCG Manavata cancer centre, Nashik, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20174346

Keywords:

PCF, Pharyngocutaneous, Fistula, SCM Flap

Abstract

Incidence of post chemoradiation salvage laryngectomy complication rate is 3%-65%. It is most common but most annoying complication after salvage laryngectomy for surgeon to manage. When conservative measures fail to repair the fistula surgical means have to be considered. But even after surgical correction it takes time to heal due to local conditions. Here we present a case of surgical repair of pharyngocutaneous fistula and review of various management strategies.

References

Dirven R, Swinson BD, Gao K, Clark JR. The assessment of pharyngocutaneous fistula rate in patients treated primarily with definitive radiotherapy followed by salvage surgery of the larynx and hypopharynx. Laryngoscope. 2009;119(9):1691-5.

Johansen LV, Overgaard J, Elbrond O. Pharyngo-cutaneous fistulae after laryngectomy. Influence of previous radiotherapy and prophylactic metronidazole. Cancer. 1988;61(4):673-8.

Eisbruch A, Lyden T, Bradford CR, Dawson LA, Haxer MJ, Miller AE, et al Objective assessment of swallowing dysfunction and aspiration after radiation concurrent with chemotherapy for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2002;53(1):23-8.

Hillman RE, Walsh MJ, Wolf GT, Fisher SG, Hong WK: Functional outcomes following treatment for advanced laryngeal cancer; Ann Otol Rhinol Laryngol Suppl. 1998;172:1-27.

Lazarus CL, Logemann JA, Pauloski BR, Colangelo LA, Kahrilas PJ, Mittal BB, et al. Swallowing disorders in head and neck cancer patients treated with radiotherapy and adjuvant chemotherapy. Laryngoscope. 1996;106(9):1157-66.

Delanian S, Lefaix JL. The radiation-induced fibroatrophic process: therapeutic perspective via the antioxidant pathway. Radiother Oncol. 2004;73(2):119-31.

Önder T, Bekir A, Ergen D. Repair of a large pharyngocutaneous fistula with the free dorsalis pedis flap. Eur J Gen Med. 2007;4(1):39-43

Guha G, Saha S, Kundu I. Surgical Repair of Postlaryngectomy Pharyngocutaneous Fistulas. Indian J Otolaryngol Head Neck Surg. 2007;59:103-7.

Bootz F, Müller GH Repair of salivary fistulae after laryngectomy. Clin Otolaryngol Allied Sci. 1990;15(4):299-302.

Jianu J. Paralizie faciale dupa extirparea unei turmoi a parotidei, trata prin operatia Dlui Gomoiu. Bull Mem Soc De Chir de Bucharest. 1908;102:377-86.

Owens N. A compound neck pedicle designed for the repair of massive facial defects: formation, development and application. Plast Reconstr Surg. 1955;15:369-89.

Janssen DA, Thimsen DA. The extended submental island lip flap: An alternative for esophageal repair. Plast Recons Surg. 1998;102:835-8.

Downloads

Published

2017-09-22