[The management of pharyngocutaneous fistulas after total laryngectomy and the factors affecting their incidence].
OBJECTIVE
This study sought to determine the incidence and etiologic factors of pharyngocutaneous fistulas occurring after total laryngectomy.


METHODS
A total of 138 patients (136 males, 2 females; mean age 59.5 years; range 36 to 83 years) underwent total laryngectomy for squamous cell carcinoma. Risk factors and the management of pharyngocutaneous fistulas were assessed together with durations in relation to fistula occurrence, oral feeding, hospitalization, and healing.


RESULTS
Pharyngocutaneous fistulas were seen in 37 patients (26.8%). Significantly high rates of fistula occurrence were detected in patients with alcohol consumption (p=0.032), and in those who underwent partial pharyngectomy (p=0.058) or bilateral neck dissection (p=0.049) along with total laryngectomy. The occurrence of fistulas was significantly associated with prolonged lengths of time for oral feeding and hospital stay (p<0.001). Fistulas were repaired surgically in 24.3% of patients, in whom the time to oral feeding was significantly shorter than that of patients who received local wound care (p=0.03).


CONCLUSIONS
Our data show that early surgical intervention is more beneficial in preventing further morbidity associated with pharyngocutaneous fistulas.
Kasapoğlu
Fikret
F
Department of Otolaryngology, Medicine Faculty of Uludağ University, Bursa, Turkey.
Erişen
Levent
L
Coşkun
Hakan
H
Basut
Oğuz
O
Tezel
Ilker
I
Hizalan
Ibrahim
I
Onart
Selçuk
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D017577:Cutaneous Fistula / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010608:Pharyngeal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D011183:Postoperative Complications; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology